| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,069 |
324 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
698 |
683 |
$28K |
| V2020 |
Frames, purchases |
763 |
476 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
291 |
284 |
$12K |
| V2760 |
Scratch resistant coating, per lens |
112 |
39 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
932 |
277 |
$530.00 |