| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
959 |
720 |
$12K |
| V2020 |
Frames, purchases |
1,204 |
923 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
627 |
476 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
583 |
450 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
750 |
589 |
$7K |
| V2781 |
Progressive lens, per lens |
104 |
99 |
$4K |
| V2299 |
Specialty bifocal (by report) |
104 |
99 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
29 |
26 |
$754.00 |
| 92015 |
Determination of refractive state |
652 |
531 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
81 |
71 |
$0.00 |