| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
742 |
702 |
$27K |
| V2020 |
Frames, purchases |
802 |
751 |
$23K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
428 |
412 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
423 |
411 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
365 |
361 |
$15K |
| 92015 |
Determination of refractive state |
825 |
812 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
345 |
326 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
392 |
345 |
$5K |