| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,059 |
1,623 |
$136K |
| V2020 |
Frames, purchases |
2,352 |
1,712 |
$101K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,312 |
1,293 |
$53K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
948 |
931 |
$43K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
158 |
157 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
505 |
399 |
$5K |
| V2025 |
Deluxe frame |
156 |
151 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
31 |
19 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,304 |
629 |
$870.00 |