| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
415 |
335 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
602 |
549 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
549 |
492 |
$24K |
| V2020 |
Frames, purchases |
323 |
297 |
$9K |
| 92015 |
Determination of refractive state |
465 |
447 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
126 |
123 |
$3K |
| V2025 |
Deluxe frame |
175 |
129 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
43 |
42 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
137 |
128 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$1K |