| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
667 |
578 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
201 |
175 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
155 |
111 |
$4K |
| V2781 |
Progressive lens, per lens |
78 |
67 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
141 |
92 |
$2K |
| V2299 |
Specialty bifocal (by report) |
77 |
66 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
72 |
45 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
88 |
42 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
57 |
51 |
$920.56 |
| V2025 |
Deluxe frame |
71 |
39 |
$775.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
57 |
29 |
$724.88 |
| 92015 |
Determination of refractive state |
223 |
177 |
$342.36 |