| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,235 |
3,000 |
$216K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,353 |
1,228 |
$124K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,363 |
3,105 |
$121K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,936 |
2,767 |
$119K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
753 |
687 |
$115K |
| 92060 |
|
1,654 |
1,504 |
$110K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,605 |
1,573 |
$87K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
354 |
318 |
$47K |
| 92015 |
Determination of refractive state |
1,815 |
1,670 |
$37K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
862 |
582 |
$33K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
350 |
229 |
$13K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
157 |
95 |
$7K |