| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
671 |
625 |
$148K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
335 |
322 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
163 |
152 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
413 |
375 |
$209.00 |
| 92015 |
Determination of refractive state |
417 |
409 |
$97.57 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
594 |
557 |
$48.96 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
130 |
130 |
$11.00 |