| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,767 |
1,650 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,227 |
1,192 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
755 |
703 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
558 |
539 |
$22K |
| 92015 |
Determination of refractive state |
1,650 |
1,570 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,253 |
1,219 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
227 |
223 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
75 |
72 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
36 |
$570.00 |