| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
675 |
673 |
$17K |
| V2020 |
Frames, purchases |
651 |
649 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
801 |
399 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
266 |
234 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
387 |
244 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
14 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
50 |
37 |
$304.00 |
| 92015 |
Determination of refractive state |
69 |
69 |
$0.00 |