| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
317 |
312 |
$5K |
| V2020 |
Frames, purchases |
779 |
769 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
91 |
66 |
$902.16 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
668 |
656 |
$588.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
232 |
187 |
$558.48 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
26 |
24 |
$373.20 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
161 |
157 |
$0.00 |
| 92015 |
Determination of refractive state |
350 |
280 |
$0.00 |