| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
422 |
395 |
$7K |
| V2020 |
Frames, purchases |
475 |
444 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
255 |
237 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
200 |
176 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
295 |
274 |
$2K |
| 92015 |
Determination of refractive state |
144 |
133 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
70 |
62 |
$0.00 |