| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
443 |
443 |
$38K |
| V2020 |
Frames, purchases |
404 |
403 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
271 |
270 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
438 |
437 |
$14K |
| 92015 |
Determination of refractive state |
560 |
559 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
124 |
122 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$2K |