| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
990 |
966 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
735 |
720 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
561 |
553 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
885 |
864 |
$4K |
| 92015 |
Determination of refractive state |
1,147 |
1,131 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
255 |
245 |
$1K |
| V2756 |
Eye glass case |
791 |
771 |
$58.50 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
147 |
146 |
$41.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$0.00 |
| 92133 |
|
39 |
39 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
41 |
40 |
$0.00 |
| 92100 |
|
39 |
39 |
$0.00 |