| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,003 |
1,979 |
$54K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
874 |
867 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
438 |
433 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
355 |
354 |
$8K |
| 92002 |
|
109 |
109 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
151 |
148 |
$5K |
| V2756 |
Eye glass case |
1,905 |
1,887 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
28 |
28 |
$2K |
| 92015 |
Determination of refractive state |
124 |
123 |
$30.10 |