| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,352 |
1,232 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
231 |
221 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
230 |
222 |
$5K |
| 92015 |
Determination of refractive state |
588 |
563 |
$672.55 |
| V2020 |
Frames, purchases |
1,214 |
1,177 |
$633.10 |
| 92341 |
|
94 |
93 |
$588.32 |
| 92342 |
|
649 |
644 |
$284.98 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,064 |
844 |
$70.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
391 |
334 |
$5.00 |
| V2025 |
Deluxe frame |
231 |
217 |
$0.00 |
| 2022F |
|
236 |
236 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
166 |
111 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
28 |
$0.00 |
| 3072F |
|
146 |
146 |
$0.00 |
| V2756 |
Eye glass case |
636 |
633 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
552 |
276 |
$0.00 |