| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,079 |
2,522 |
$56K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,886 |
1,832 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,205 |
1,045 |
$53K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,276 |
1,080 |
$52K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,810 |
1,217 |
$23K |
| 92015 |
Determination of refractive state |
3,696 |
3,263 |
$17K |
| 92002 |
|
539 |
510 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
518 |
475 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
245 |
187 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
585 |
376 |
$6K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
33 |
17 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
126 |
126 |
$750.00 |