| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,632 |
3,483 |
$99K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,652 |
3,496 |
$71K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,094 |
2,977 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,639 |
1,582 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
623 |
598 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
391 |
372 |
$29K |
| 92015 |
Determination of refractive state |
2,170 |
2,084 |
$24K |
| 92250 |
|
680 |
661 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
39 |
$880.24 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
12 |
$373.60 |