| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,051 |
754 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,033 |
782 |
$42K |
| 92015 |
Determination of refractive state |
1,278 |
1,197 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,565 |
1,125 |
$27K |
| V2020 |
Frames, purchases |
1,536 |
1,095 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
158 |
154 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
121 |
81 |
$2K |
| 92250 |
|
15 |
15 |
$517.05 |