| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,423 |
1,133 |
$36K |
| 92015 |
Determination of refractive state |
1,243 |
987 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
423 |
345 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,233 |
976 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
222 |
215 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
551 |
449 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
91 |
87 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
278 |
186 |
$5K |
| 92002 |
|
48 |
48 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
49 |
41 |
$1K |