| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,287 |
1,254 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
559 |
553 |
$25K |
| 92015 |
Determination of refractive state |
904 |
898 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
97 |
97 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,198 |
1,178 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
614 |
603 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
29 |
29 |
$0.00 |
| V2020 |
Frames, purchases |
1,325 |
1,297 |
$0.00 |