| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
1,196 |
1,195 |
$58K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
826 |
799 |
$36K |
| V2020 |
Frames, purchases |
1,289 |
1,237 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,689 |
1,673 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
796 |
763 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
95 |
93 |
$4K |
| 92015 |
Determination of refractive state |
256 |
248 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
812 |
738 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
699 |
647 |
$301.00 |
| V2750 |
Anti-reflective coating, per lens |
18 |
18 |
$0.00 |