| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
758 |
755 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
760 |
757 |
$21K |
| 92015 |
Determination of refractive state |
902 |
902 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
136 |
136 |
$14K |
| V2020 |
Frames, purchases |
738 |
735 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
42 |
42 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
758 |
755 |
$0.00 |