| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,099 |
2,054 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
540 |
533 |
$62K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
676 |
661 |
$47K |
| 92015 |
Determination of refractive state |
1,833 |
1,819 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
800 |
795 |
$19K |
| V2020 |
Frames, purchases |
1,397 |
1,394 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$954.80 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$237.15 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,340 |
1,335 |
$0.00 |