| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
575 |
533 |
$34K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
531 |
517 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
219 |
196 |
$9K |
| V2020 |
Frames, purchases |
551 |
507 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
96 |
78 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
82 |
43 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
95 |
51 |
$1K |
| 92015 |
Determination of refractive state |
39 |
38 |
$390.00 |