| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
988 |
955 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
735 |
703 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
307 |
299 |
$10K |
| 92015 |
Determination of refractive state |
919 |
893 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
169 |
169 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
105 |
105 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
194 |
194 |
$2K |