| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
368 |
365 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
386 |
382 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
318 |
315 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
139 |
137 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
380 |
377 |
$11K |
| 92015 |
Determination of refractive state |
451 |
437 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
46 |
45 |
$6K |