| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
335 |
312 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
263 |
240 |
$6K |
| 92015 |
Determination of refractive state |
275 |
251 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
58 |
52 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
55 |
39 |
$3K |
| V2020 |
Frames, purchases |
393 |
362 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$2K |