| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,310 |
1,276 |
$69K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
906 |
888 |
$34K |
| 92015 |
Determination of refractive state |
1,337 |
1,294 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
752 |
733 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
814 |
795 |
$16K |
| V2020 |
Frames, purchases |
1,300 |
1,272 |
$16K |
| 92002 |
|
244 |
236 |
$10K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
55 |
55 |
$3K |
| 92341 |
|
25 |
25 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
25 |
$939.36 |