| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
965 |
937 |
$40K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,594 |
1,109 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
247 |
227 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
973 |
953 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
384 |
295 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
116 |
107 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
147 |
144 |
$10K |
| 92002 |
|
28 |
28 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$578.93 |