| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
671 |
669 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
646 |
644 |
$41K |
| 92015 |
Determination of refractive state |
1,274 |
1,261 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
364 |
364 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
90 |
$7K |
| V2020 |
Frames, purchases |
173 |
172 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
18 |
$800.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
27 |
$601.02 |