| 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 |
233 |
232 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
363 |
342 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
85 |
85 |
$8K |
| V2020 |
Frames, purchases |
338 |
336 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
347 |
345 |
$6K |
| 92015 |
Determination of refractive state |
350 |
349 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |