| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,449 |
2,384 |
$182K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,038 |
1,986 |
$170K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
897 |
867 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
613 |
585 |
$58K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
753 |
732 |
$55K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,660 |
1,622 |
$46K |
| 92015 |
Determination of refractive state |
2,920 |
2,827 |
$38K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
359 |
350 |
$35K |
| 92250 |
|
801 |
773 |
$33K |
| 92341 |
|
1,033 |
1,014 |
$27K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
397 |
390 |
$5K |
| V2025 |
Deluxe frame |
30 |
30 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
83 |
83 |
$791.12 |