| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,949 |
3,839 |
$176K |
| V2020 |
Frames, purchases |
3,854 |
3,710 |
$153K |
| 92015 |
Determination of refractive state |
4,301 |
4,143 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
650 |
635 |
$45K |
| 92002 |
|
863 |
842 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,216 |
1,175 |
$33K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
827 |
788 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
590 |
572 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,248 |
1,197 |
$22K |
| 92341 |
|
168 |
163 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
162 |
153 |
$8K |
| V2756 |
Eye glass case |
3,325 |
3,199 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
54 |
$2K |
| 92250 |
|
28 |
28 |
$615.62 |