| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,928 |
5,788 |
$257K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,749 |
3,664 |
$253K |
| 92015 |
Determination of refractive state |
8,300 |
8,100 |
$225K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,759 |
1,676 |
$148K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,487 |
1,474 |
$41K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
632 |
612 |
$27K |
| V2020 |
Frames, purchases |
1,713 |
1,701 |
$19K |
| 92002 |
|
15 |
15 |
$676.65 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$669.60 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,712 |
1,700 |
$636.00 |