| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
640 |
593 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
549 |
518 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
617 |
572 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
223 |
216 |
$10K |
| 92015 |
Determination of refractive state |
696 |
657 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
45 |
45 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
15 |
$931.28 |
| V2025 |
Deluxe frame |
25 |
25 |
$0.00 |