| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,892 |
4,465 |
$104K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,151 |
3,728 |
$91K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,770 |
1,766 |
$77K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,736 |
1,732 |
$77K |
| 92015 |
Determination of refractive state |
3,554 |
3,551 |
$34K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
140 |
131 |
$12K |
| 92341 |
|
343 |
335 |
$11K |
| 92250 |
|
125 |
123 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
29 |
15 |
$535.92 |