| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
8,831 |
8,359 |
$252K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,312 |
7,885 |
$229K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,458 |
2,447 |
$229K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,495 |
2,473 |
$190K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,427 |
4,181 |
$113K |
| 92015 |
Determination of refractive state |
6,559 |
6,504 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,975 |
2,769 |
$37K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
735 |
721 |
$20K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
112 |
110 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
36 |
36 |
$835.27 |
| 92370 |
|
12 |
12 |
$69.05 |
| 92341 |
|
48 |
47 |
$31.70 |