| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
917 |
879 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
164 |
164 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
199 |
197 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
93 |
87 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
403 |
390 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
249 |
233 |
$3K |
| 92015 |
Determination of refractive state |
363 |
355 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
58 |
56 |
$1K |