| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,984 |
1,573 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,159 |
977 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,582 |
1,233 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
787 |
666 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
226 |
163 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$468.80 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
13 |
$278.21 |
| 92015 |
Determination of refractive state |
36 |
28 |
$240.84 |