| Code | Description | Claims | Beneficiaries | Total Paid |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31,732 |
10,117 |
$864K |
| V2020 |
Frames, purchases |
18,391 |
12,220 |
$723K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,302 |
8,169 |
$360K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,306 |
6,198 |
$276K |
| V2750 |
Anti-reflective coating, per lens |
3,245 |
1,327 |
$65K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,424 |
687 |
$54K |
| V2744 |
Tint, photochromatic, per lens |
1,375 |
601 |
$45K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26,360 |
7,707 |
$35K |
| V2760 |
Scratch resistant coating, per lens |
2,891 |
990 |
$27K |
| V2299 |
Specialty bifocal (by report) |
696 |
345 |
$26K |
| V2781 |
Progressive lens, per lens |
704 |
349 |
$25K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
112 |
108 |
$9K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
196 |
88 |
$6K |
| 92015 |
Determination of refractive state |
7,538 |
7,402 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
365 |
349 |
$4K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
214 |
106 |
$1K |
| 92310 |
|
14 |
14 |
$741.36 |