| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,442 |
2,332 |
$102K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,813 |
1,740 |
$90K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,781 |
1,680 |
$80K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
432 |
419 |
$41K |
| 92015 |
Determination of refractive state |
3,340 |
3,157 |
$19K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
12 |
$817.68 |
| 3072F |
|
12 |
12 |
$0.00 |