| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
92 |
90 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
48 |
48 |
$4K |
| V2020 |
Frames, purchases |
120 |
118 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
135 |
116 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
27 |
$3K |
| 92015 |
Determination of refractive state |
196 |
195 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
117 |
115 |
$2K |