| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,538 |
6,199 |
$198K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,898 |
1,780 |
$159K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,450 |
5,159 |
$152K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,915 |
1,810 |
$145K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,107 |
5,813 |
$133K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,977 |
2,830 |
$82K |
| 92015 |
Determination of refractive state |
5,734 |
5,397 |
$62K |
| 92341 |
|
44 |
40 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
42 |
$962.76 |
| 92370 |
|
24 |
24 |
$508.47 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |