| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,129 |
2,034 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
801 |
800 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,255 |
1,196 |
$25K |
| 92002 |
|
556 |
497 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
312 |
303 |
$14K |
| V2025 |
Deluxe frame |
234 |
234 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
182 |
174 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
52 |
52 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
40 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$247.50 |