| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,387 |
5,279 |
$415K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,655 |
2,615 |
$303K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,838 |
2,783 |
$173K |
| 92250 |
|
4,972 |
4,859 |
$147K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,137 |
4,093 |
$135K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
885 |
859 |
$112K |
| 92015 |
Determination of refractive state |
5,447 |
5,222 |
$95K |
| V2760 |
Scratch resistant coating, per lens |
1,512 |
1,483 |
$43K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
161 |
160 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
38 |
$2K |
| 92341 |
|
12 |
12 |
$456.12 |