| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
351 |
326 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
263 |
260 |
$10K |
| V2020 |
Frames, purchases |
328 |
314 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
65 |
65 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
67 |
67 |
$3K |
| V2025 |
Deluxe frame |
28 |
28 |
$332.64 |