| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
606 |
582 |
$24K |
| 92015 |
Determination of refractive state |
1,267 |
1,240 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
269 |
266 |
$15K |
| V2020 |
Frames, purchases |
343 |
325 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
211 |
203 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
24 |
24 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
72 |
68 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
26 |
$302.12 |
| V2756 |
Eye glass case |
284 |
273 |
$269.76 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
12 |
$233.60 |