| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,640 |
1,541 |
$118K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
948 |
884 |
$91K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
697 |
683 |
$72K |
| 92015 |
Determination of refractive state |
1,881 |
1,783 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,465 |
1,372 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,533 |
892 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
201 |
135 |
$195.00 |
| 92250 |
|
48 |
48 |
$86.49 |
| V2755 |
U-v lens, per lens |
28 |
28 |
$0.00 |