| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
502 |
336 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
581 |
365 |
$26K |
| V2020 |
Frames, purchases |
532 |
342 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
80 |
80 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
71 |
70 |
$913.06 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
14 |
13 |
$630.00 |