| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
859 |
856 |
$92K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
692 |
691 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
282 |
282 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
184 |
184 |
$11K |
| 92015 |
Determination of refractive state |
672 |
672 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
209 |
209 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
283 |
282 |
$3K |