| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
374 |
358 |
$10K |
| 92015 |
Determination of refractive state |
421 |
407 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
127 |
124 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
205 |
198 |
$7K |
| V2020 |
Frames, purchases |
422 |
406 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
27 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
98 |
95 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
19 |
12 |
$253.90 |
| V2702 |
Deluxe lens feature |
142 |
138 |
$0.00 |