| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,987 |
2,673 |
$117K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,401 |
1,279 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
801 |
739 |
$52K |
| V2755 |
U-v lens, per lens |
2,520 |
2,260 |
$49K |
| 92015 |
Determination of refractive state |
2,811 |
2,581 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
869 |
763 |
$39K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
334 |
296 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$648.48 |
| V2799 |
Vision item or service, miscellaneous |
57 |
50 |
$10.00 |