| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,699 |
1,639 |
$127K |
| 92250 |
|
1,528 |
1,494 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
349 |
341 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
953 |
927 |
$30K |
| 92015 |
Determination of refractive state |
1,750 |
1,657 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
287 |
237 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
87 |
87 |
$11K |
| V2760 |
Scratch resistant coating, per lens |
269 |
266 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$706.80 |