| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,317 |
1,253 |
$44K |
| V2020 |
Frames, purchases |
1,427 |
1,359 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
990 |
929 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
937 |
899 |
$39K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
523 |
513 |
$24K |
| 92015 |
Determination of refractive state |
1,560 |
1,542 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
757 |
716 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
889 |
823 |
$11K |
| V2025 |
Deluxe frame |
13 |
13 |
$520.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$293.48 |