| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
267 |
257 |
$15K |
| 92015 |
Determination of refractive state |
631 |
580 |
$9K |
| V2020 |
Frames, purchases |
241 |
236 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
99 |
57 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
27 |
25 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
15 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
52 |
25 |
$578.76 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$426.24 |
| V2756 |
Eye glass case |
218 |
210 |
$245.12 |