| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
462 |
458 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
219 |
215 |
$13K |
| 92015 |
Determination of refractive state |
412 |
402 |
$6K |
| V2020 |
Frames, purchases |
519 |
509 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
113 |
113 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
254 |
248 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
182 |
179 |
$5K |
| 92002 |
|
44 |
41 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
55 |
54 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$527.02 |
| 92341 |
|
13 |
12 |
$513.48 |
| V2756 |
Eye glass case |
414 |
407 |
$447.74 |
| V2760 |
Scratch resistant coating, per lens |
27 |
27 |
$256.50 |