| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,454 |
3,329 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,115 |
1,962 |
$43K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,292 |
659 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
457 |
457 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
448 |
224 |
$616.20 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
90 |
45 |
$400.12 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
13 |
$195.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
704 |
330 |
$0.00 |
| V2755 |
U-v lens, per lens |
3,846 |
1,839 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
64 |
64 |
$0.00 |