| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,326 |
1,130 |
$97K |
| V2020 |
Frames, purchases |
1,303 |
1,084 |
$85K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,279 |
1,089 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
293 |
280 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
463 |
401 |
$24K |
| 92015 |
Determination of refractive state |
930 |
763 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
31 |
28 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
48 |
44 |
$3K |
| V2715 |
Prism, per lens |
12 |
12 |
$259.48 |