| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
930 |
903 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
599 |
584 |
$27K |
| 92015 |
Determination of refractive state |
1,236 |
1,212 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
914 |
889 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
885 |
858 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
263 |
256 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
408 |
395 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
25 |
24 |
$690.00 |