| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
599 |
589 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
224 |
223 |
$11K |
| 92015 |
Determination of refractive state |
839 |
833 |
$8K |
| V2020 |
Frames, purchases |
617 |
606 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
381 |
371 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
94 |
94 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
617 |
607 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
25 |
25 |
$250.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
16 |
$224.00 |