| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,429 |
1,213 |
$127K |
| 92002 |
|
2,813 |
2,488 |
$100K |
| 92015 |
Determination of refractive state |
4,240 |
3,759 |
$80K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,280 |
1,122 |
$38K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
361 |
231 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
111 |
82 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
394 |
190 |
$1K |