| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
756 |
568 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
220 |
179 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
38 |
25 |
$2K |
| V2020 |
Frames, purchases |
137 |
109 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
26 |
$341.88 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
28 |
$311.84 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
140 |
109 |
$0.00 |