| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
1,544 |
1,331 |
$87K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,263 |
2,173 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,227 |
1,081 |
$19K |
| V2020 |
Frames, purchases |
974 |
907 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
54 |
54 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
473 |
276 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
68 |
65 |
$1K |