| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,149 |
4,004 |
$76K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,183 |
2,148 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,859 |
1,824 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
930 |
888 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,310 |
1,243 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
249 |
246 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
141 |
138 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
115 |
108 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
40 |
40 |
$1K |
| 92015 |
Determination of refractive state |
253 |
253 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
18 |
14 |
$0.00 |