| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,026 |
1,711 |
$124K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
999 |
881 |
$85K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
580 |
542 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,755 |
1,482 |
$12K |
| 92015 |
Determination of refractive state |
1,863 |
1,628 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,144 |
1,101 |
$8K |
| 92341 |
|
36 |
36 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
73 |
42 |
$255.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
53 |
28 |
$90.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
20 |
$21.66 |
| V2755 |
U-v lens, per lens |
183 |
133 |
$0.00 |
| 92250 |
|
16 |
15 |
$0.00 |