| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,570 |
1,518 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
835 |
833 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
656 |
637 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
810 |
785 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
509 |
505 |
$9K |
| 92015 |
Determination of refractive state |
224 |
223 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
226 |
225 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
286 |
284 |
$1K |
| V2025 |
Deluxe frame |
12 |
12 |
$576.00 |