| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,048 |
1,026 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
842 |
827 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
800 |
780 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
402 |
401 |
$18K |
| V2025 |
Deluxe frame |
204 |
203 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
299 |
297 |
$5K |
| 92015 |
Determination of refractive state |
436 |
433 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
209 |
182 |
$836.92 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
14 |
$750.75 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81 |
81 |
$35.00 |