| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,387 |
5,830 |
$522K |
| V2020 |
Frames, purchases |
6,553 |
5,973 |
$157K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,708 |
1,696 |
$147K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,373 |
1,358 |
$141K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,056 |
5,522 |
$117K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,490 |
4,928 |
$110K |
| 92015 |
Determination of refractive state |
6,971 |
6,822 |
$87K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,000 |
993 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
364 |
350 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
69 |
63 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$213.86 |