| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,658 |
1,597 |
$50K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,069 |
1,030 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
684 |
669 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
392 |
389 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
387 |
375 |
$7K |
| 92015 |
Determination of refractive state |
273 |
263 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
184 |
176 |
$3K |
| V2025 |
Deluxe frame |
35 |
35 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
266 |
255 |
$973.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
13 |
$170.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$130.00 |