| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,328 |
2,318 |
$29K |
| 92002 |
|
725 |
725 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
592 |
588 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,032 |
513 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
801 |
520 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
87 |
85 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
52 |
52 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,092 |
1,081 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$400.12 |
| V2755 |
U-v lens, per lens |
556 |
277 |
$0.00 |