| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
855 |
309 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
453 |
158 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,067 |
376 |
$8K |
| 92015 |
Determination of refractive state |
471 |
172 |
$6K |
| V2020 |
Frames, purchases |
1,080 |
390 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
817 |
293 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
78 |
26 |
$510.72 |