| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
970 |
900 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,060 |
982 |
$35K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
240 |
230 |
$15K |
| V2020 |
Frames, purchases |
1,076 |
989 |
$8K |
| 92015 |
Determination of refractive state |
1,375 |
1,297 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,235 |
1,139 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
12 |
$210.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
72 |
72 |
$0.00 |
| V2025 |
Deluxe frame |
108 |
102 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
46 |
46 |
$0.00 |