| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
401 |
382 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
221 |
217 |
$13K |
| 92015 |
Determination of refractive state |
821 |
772 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
126 |
123 |
$8K |
| V2199 |
Not otherwise classified, single vision lens |
36 |
34 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
54 |
54 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
57 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$837.32 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$616.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
16 |
$461.12 |
| V2756 |
Eye glass case |
324 |
313 |
$361.50 |