| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
559 |
536 |
$32K |
| V2020 |
Frames, purchases |
821 |
784 |
$32K |
| 92015 |
Determination of refractive state |
1,312 |
1,224 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
117 |
108 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
159 |
151 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
99 |
93 |
$2K |
| 92002 |
|
45 |
38 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
25 |
25 |
$1K |
| V2756 |
Eye glass case |
620 |
588 |
$719.02 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$256.41 |