| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
312 |
291 |
$16K |
| 92015 |
Determination of refractive state |
609 |
515 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
148 |
140 |
$8K |
| V2020 |
Frames, purchases |
399 |
370 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
236 |
211 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
49 |
49 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$913.44 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$420.51 |
| V2756 |
Eye glass case |
397 |
372 |
$411.86 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$144.00 |