| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
960 |
945 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
126 |
120 |
$5K |
| 92015 |
Determination of refractive state |
340 |
332 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$560.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
234 |
231 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
26 |
24 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
37 |
33 |
$0.00 |
| V2020 |
Frames, purchases |
803 |
785 |
$0.00 |