| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
3,082 |
3,063 |
$141K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,133 |
3,062 |
$131K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,725 |
1,690 |
$75K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,887 |
2,882 |
$43K |
| V2020 |
Frames, purchases |
1,008 |
983 |
$34K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,168 |
1,150 |
$27K |
| 92015 |
Determination of refractive state |
2,770 |
2,706 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,266 |
2,231 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,046 |
1,041 |
$270.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
64 |
62 |
$90.00 |