| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
295 |
277 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
469 |
458 |
$15K |
| 92015 |
Determination of refractive state |
1,226 |
1,201 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
311 |
307 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
224 |
212 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
93 |
90 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
93 |
93 |
$2K |
| V2756 |
Eye glass case |
480 |
449 |
$662.99 |
| V2025 |
Deluxe frame |
123 |
123 |
$0.00 |