| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
187 |
178 |
$13K |
| V2020 |
Frames, purchases |
164 |
155 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
109 |
100 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
30 |
27 |
$2K |
| 92015 |
Determination of refractive state |
106 |
93 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
57 |
47 |
$956.05 |
| V2756 |
Eye glass case |
99 |
91 |
$97.68 |