| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,419 |
2,346 |
$95K |
| V2020 |
Frames, purchases |
2,496 |
2,411 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,649 |
1,612 |
$46K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
756 |
743 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
243 |
241 |
$22K |
| 92015 |
Determination of refractive state |
736 |
727 |
$10K |
| 92341 |
|
287 |
282 |
$9K |
| 92250 |
|
128 |
125 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
79 |
79 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$2K |