| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
530 |
515 |
$15K |
| 92015 |
Determination of refractive state |
567 |
564 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
110 |
110 |
$6K |
| V2020 |
Frames, purchases |
424 |
419 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
94 |
94 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
242 |
124 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$2K |