| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,491 |
1,488 |
$33K |
| V2020 |
Frames, purchases |
1,369 |
1,367 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,428 |
716 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
741 |
653 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
850 |
518 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
63 |
63 |
$5K |
| V2025 |
Deluxe frame |
135 |
134 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
26 |
25 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
134 |
96 |
$814.72 |
| 92015 |
Determination of refractive state |
149 |
149 |
$0.00 |