| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,176 |
976 |
$69K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
512 |
452 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
596 |
541 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
392 |
335 |
$20K |
| 92015 |
Determination of refractive state |
2,158 |
1,913 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
545 |
501 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
440 |
411 |
$11K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
81 |
66 |
$4K |
| 92341 |
|
155 |
107 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
50 |
$3K |
| V2756 |
Eye glass case |
1,521 |
1,333 |
$2K |
| V2025 |
Deluxe frame |
375 |
374 |
$0.00 |