| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
536 |
486 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
515 |
472 |
$14K |
| 92015 |
Determination of refractive state |
724 |
639 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
480 |
447 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
51 |
50 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
346 |
314 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$950.43 |