| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
577 |
541 |
$29K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
419 |
418 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
312 |
275 |
$13K |
| V2020 |
Frames, purchases |
569 |
527 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
132 |
115 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
149 |
115 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
165 |
128 |
$2K |
| 92015 |
Determination of refractive state |
161 |
161 |
$2K |