| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,237 |
2,126 |
$65K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,211 |
2,100 |
$58K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,233 |
1,164 |
$52K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
685 |
637 |
$37K |
| V2020 |
Frames, purchases |
2,288 |
2,123 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
406 |
390 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,281 |
1,198 |
$21K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
100 |
95 |
$6K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
34 |
30 |
$604.34 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
197 |
180 |
$109.04 |
| V2744 |
Tint, photochromatic, per lens |
40 |
38 |
$0.00 |
| V2781 |
Progressive lens, per lens |
15 |
12 |
$0.00 |