| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,437 |
4,344 |
$273K |
| V2020 |
Frames, purchases |
4,039 |
3,935 |
$118K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,109 |
2,042 |
$117K |
| 92015 |
Determination of refractive state |
4,144 |
3,987 |
$67K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
738 |
724 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,837 |
2,637 |
$48K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,240 |
2,185 |
$22K |
| 92250 |
|
453 |
400 |
$19K |
| 92341 |
|
188 |
183 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
250 |
245 |
$9K |
| V2756 |
Eye glass case |
4,366 |
4,259 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
40 |
$2K |
| 92002 |
|
31 |
31 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
50 |
50 |
$714.66 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$170.34 |