| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,345 |
1,300 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
414 |
412 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
560 |
543 |
$13K |
| V2025 |
Deluxe frame |
540 |
499 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
371 |
354 |
$10K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
68 |
68 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
37 |
37 |
$3K |
| V2799 |
Vision item or service, miscellaneous |
247 |
219 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
17 |
14 |
$59.28 |