| 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 |
957 |
497 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
371 |
371 |
$14K |
| V2020 |
Frames, purchases |
876 |
870 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
227 |
227 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
78 |
39 |
$821.60 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
52 |
52 |
$780.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
32 |
16 |
$0.00 |