| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,671 |
3,478 |
$116K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,555 |
3,372 |
$111K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,478 |
1,401 |
$85K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,314 |
2,203 |
$82K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,456 |
3,312 |
$72K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,018 |
945 |
$56K |
| 92015 |
Determination of refractive state |
2,882 |
2,717 |
$32K |
| 92341 |
|
600 |
575 |
$15K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
200 |
186 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
104 |
93 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$850.19 |