| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
781 |
779 |
$22K |
| V2020 |
Frames, purchases |
842 |
836 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
268 |
268 |
$9K |
| 92015 |
Determination of refractive state |
360 |
360 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
335 |
332 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
299 |
299 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$818.24 |