| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,883 |
1,776 |
$103K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,688 |
1,618 |
$72K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,119 |
1,073 |
$43K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,558 |
1,455 |
$8K |
| 92015 |
Determination of refractive state |
2,869 |
2,741 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,114 |
1,042 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
223 |
217 |
$374.81 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
54 |
53 |
$196.98 |
| 92341 |
|
57 |
55 |
$15.00 |