| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,717 |
3,620 |
$91K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,039 |
1,996 |
$90K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,533 |
1,513 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,069 |
2,019 |
$58K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,141 |
2,114 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
941 |
930 |
$13K |
| 92015 |
Determination of refractive state |
442 |
425 |
$9K |
| V2025 |
Deluxe frame |
419 |
415 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
30 |
30 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
911 |
891 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
96 |
88 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
127 |
126 |
$0.00 |