| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
692 |
659 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
794 |
758 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
301 |
297 |
$24K |
| 92015 |
Determination of refractive state |
1,143 |
1,099 |
$6K |
| V2020 |
Frames, purchases |
705 |
677 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
955 |
915 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$559.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
39 |
39 |
$0.00 |
| V2025 |
Deluxe frame |
183 |
169 |
$0.00 |