| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,233 |
1,192 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,047 |
1,019 |
$37K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
644 |
631 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
556 |
542 |
$15K |
| 92015 |
Determination of refractive state |
1,026 |
988 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
545 |
532 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
118 |
111 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
16 |
$462.93 |
| 92002 |
|
12 |
12 |
$453.16 |
| V2756 |
Eye glass case |
161 |
157 |
$188.19 |