| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
11,119 |
10,524 |
$323K |
| V2020 |
Frames, purchases |
2,671 |
2,639 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,162 |
2,139 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,124 |
2,104 |
$13K |
| 92015 |
Determination of refractive state |
710 |
704 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
504 |
495 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
51 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
50 |
50 |
$752.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
57 |
57 |
$657.90 |