| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
481 |
432 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
770 |
700 |
$23K |
| V2020 |
Frames, purchases |
724 |
658 |
$11K |
| 92015 |
Determination of refractive state |
1,059 |
960 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
819 |
736 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
185 |
165 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
115 |
97 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
15 |
15 |
$1K |
| V2025 |
Deluxe frame |
117 |
96 |
$-130.00 |