| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,495 |
986 |
$69K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
428 |
303 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
679 |
658 |
$19K |
| V2025 |
Deluxe frame |
1,409 |
922 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
220 |
215 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
125 |
125 |
$6K |
| 92341 |
|
171 |
171 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
110 |
110 |
$5K |
| V2020 |
Frames, purchases |
200 |
119 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
59 |
59 |
$3K |