| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,678 |
1,568 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,654 |
1,565 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,166 |
830 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
178 |
167 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,314 |
1,222 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
63 |
57 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
951 |
886 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
77 |
55 |
$840.38 |
| 92015 |
Determination of refractive state |
481 |
454 |
$0.00 |