| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
911 |
909 |
$22K |
| V2020 |
Frames, purchases |
984 |
982 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
249 |
249 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
210 |
210 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,092 |
1,090 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
102 |
102 |
$5K |
| 92002 |
|
44 |
44 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
45 |
45 |
$1K |
| V2025 |
Deluxe frame |
56 |
56 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$237.72 |
| 92015 |
Determination of refractive state |
411 |
405 |
$0.00 |