| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,387 |
1,359 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,082 |
1,058 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
281 |
281 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
152 |
152 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
308 |
299 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
85 |
84 |
$1K |
| 92015 |
Determination of refractive state |
12 |
12 |
$0.00 |