| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,846 |
1,669 |
$96K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
500 |
438 |
$40K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
424 |
356 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,257 |
1,112 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,149 |
642 |
$6K |
| 92015 |
Determination of refractive state |
1,303 |
1,147 |
$6K |
| 92341 |
|
162 |
158 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
149 |
101 |
$40.00 |
| V2755 |
U-v lens, per lens |
359 |
332 |
$3.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
21 |
15 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |