| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,197 |
2,046 |
$67K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,053 |
1,919 |
$64K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,331 |
1,238 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,171 |
1,123 |
$48K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
748 |
728 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,323 |
1,211 |
$27K |
| 92015 |
Determination of refractive state |
1,910 |
1,894 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,518 |
1,367 |
$19K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
52 |
52 |
$2K |
| 92341 |
|
15 |
15 |
$422.10 |