| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
1,563 |
1,563 |
$78K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,439 |
1,393 |
$64K |
| V2020 |
Frames, purchases |
1,514 |
1,440 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,205 |
1,155 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,850 |
1,813 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
268 |
267 |
$13K |
| 92015 |
Determination of refractive state |
593 |
586 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,194 |
1,070 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
964 |
915 |
$517.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
64 |
55 |
$110.00 |
| V2750 |
Anti-reflective coating, per lens |
37 |
37 |
$0.00 |