| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
608 |
547 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
336 |
307 |
$15K |
| 92015 |
Determination of refractive state |
756 |
706 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
278 |
260 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
86 |
82 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
43 |
41 |
$2K |
| V2756 |
Eye glass case |
963 |
908 |
$1K |
| 92341 |
|
13 |
13 |
$390.20 |
| G9905 |
Patient not screened for tobacco use |
151 |
147 |
$0.19 |
| 1036F |
|
526 |
501 |
$0.00 |