| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
865 |
853 |
$127K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
347 |
337 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
233 |
233 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
492 |
487 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
418 |
407 |
$5K |
| 92015 |
Determination of refractive state |
1,121 |
1,099 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
376 |
376 |
$3K |
| V2025 |
Deluxe frame |
18 |
18 |
$0.00 |