| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,011 |
984 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
623 |
607 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
163 |
149 |
$14K |
| 92015 |
Determination of refractive state |
790 |
747 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
159 |
155 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
101 |
95 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
31 |
31 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
13 |
$837.42 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$590.20 |