| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,061 |
2,906 |
$227K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,727 |
1,653 |
$189K |
| 92250 |
|
3,025 |
2,904 |
$86K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
630 |
612 |
$79K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,623 |
1,261 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,231 |
2,132 |
$70K |
| 92015 |
Determination of refractive state |
3,222 |
3,013 |
$54K |
| V2760 |
Scratch resistant coating, per lens |
685 |
659 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
73 |
73 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
25 |
25 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20 |
12 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
16 |
16 |
$681.00 |