| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,430 |
1,606 |
$147K |
| V2020 |
Frames, purchases |
3,371 |
2,096 |
$109K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,614 |
1,593 |
$63K |
| 92002 |
|
715 |
714 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
863 |
857 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
202 |
81 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
113 |
113 |
$5K |
| 92015 |
Determination of refractive state |
702 |
699 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,502 |
1,623 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
20 |
20 |
$819.05 |