| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,640 |
1,592 |
$53K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,356 |
1,316 |
$39K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
757 |
720 |
$34K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
728 |
716 |
$33K |
| 92015 |
Determination of refractive state |
284 |
267 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
102 |
98 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
12 |
$641.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
12 |
$84.00 |