| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,853 |
2,630 |
$86K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,171 |
2,010 |
$54K |
| 92015 |
Determination of refractive state |
2,535 |
2,341 |
$51K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,306 |
1,244 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,550 |
1,426 |
$28K |
| 92002 |
|
657 |
612 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,692 |
2,484 |
$14K |
| 92341 |
|
375 |
351 |
$12K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
208 |
195 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
606 |
547 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
126 |
118 |
$5K |
| 92250 |
|
295 |
278 |
$4K |
| 92370 |
|
202 |
182 |
$2K |
| 00000 |
|
56 |
17 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$850.63 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
29 |
28 |
$416.25 |
| V2760 |
Scratch resistant coating, per lens |
16 |
14 |
$0.00 |