| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,928 |
1,754 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,422 |
1,307 |
$75K |
| 92015 |
Determination of refractive state |
1,674 |
1,534 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
690 |
643 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
329 |
314 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
710 |
686 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
149 |
130 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
209 |
199 |
$7K |
| 92002 |
|
155 |
147 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
94 |
91 |
$2K |
| 92341 |
|
44 |
44 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$573.15 |