| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
408 |
386 |
$19K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
328 |
318 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
288 |
275 |
$12K |
| V2020 |
Frames, purchases |
440 |
404 |
$12K |
| 92015 |
Determination of refractive state |
468 |
450 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
109 |
105 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
115 |
106 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
151 |
131 |
$2K |