| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
398 |
334 |
$17K |
| 92015 |
Determination of refractive state |
673 |
602 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
182 |
148 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
236 |
204 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
165 |
151 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
79 |
72 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$745.50 |
| 92002 |
|
14 |
14 |
$669.90 |