| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
418 |
385 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
320 |
309 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
244 |
213 |
$10K |
| V2020 |
Frames, purchases |
389 |
352 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
118 |
99 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
116 |
84 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
130 |
92 |
$2K |
| 92015 |
Determination of refractive state |
127 |
127 |
$1K |