| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
997 |
925 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
233 |
193 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
751 |
692 |
$14K |
| 92015 |
Determination of refractive state |
1,124 |
964 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
161 |
127 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
225 |
196 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
107 |
82 |
$3K |