| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
904 |
853 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
625 |
590 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
558 |
531 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
535 |
500 |
$14K |
| 92015 |
Determination of refractive state |
1,602 |
1,528 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,002 |
949 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$613.08 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
424 |
405 |
$592.18 |
| V2025 |
Deluxe frame |
28 |
27 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
88 |
80 |
$0.00 |
| S0595 |
Dispensing new spectacle lenses for patient supplied frame |
28 |
28 |
$0.00 |