| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
766 |
736 |
$11K |
| 92015 |
Determination of refractive state |
828 |
815 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
67 |
67 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
32 |
32 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
31 |
30 |
$1K |
| V2020 |
Frames, purchases |
608 |
587 |
$45.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
221 |
216 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
29 |
29 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
25 |
$0.00 |