| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,054 |
5,014 |
$126K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,525 |
1,514 |
$52K |
| 92002 |
|
749 |
745 |
$47K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
891 |
888 |
$28K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
239 |
238 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
776 |
765 |
$11K |
| 92341 |
|
195 |
194 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
82 |
81 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81 |
81 |
$828.80 |