| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
971 |
917 |
$57K |
| V2020 |
Frames, purchases |
981 |
944 |
$31K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
676 |
651 |
$13K |
| 92015 |
Determination of refractive state |
617 |
598 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
362 |
353 |
$9K |
| 92002 |
|
87 |
86 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
12 |
$886.22 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$756.84 |
| V2756 |
Eye glass case |
733 |
702 |
$717.33 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
26 |
$648.34 |