| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,092 |
2,904 |
$97K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
960 |
937 |
$95K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,814 |
2,644 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,472 |
1,403 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,350 |
2,230 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
525 |
515 |
$44K |
| 92015 |
Determination of refractive state |
2,252 |
2,187 |
$27K |
| 92250 |
|
577 |
569 |
$15K |
| 92341 |
|
42 |
38 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$671.08 |