| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
767 |
767 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
896 |
879 |
$13K |
| V2020 |
Frames, purchases |
484 |
444 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
191 |
177 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
161 |
142 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
316 |
288 |
$6K |
| 92015 |
Determination of refractive state |
105 |
92 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
496 |
460 |
$536.75 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
284 |
282 |
$42.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$16.00 |
| V2750 |
Anti-reflective coating, per lens |
24 |
24 |
$0.00 |