| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,887 |
1,833 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,594 |
1,493 |
$32K |
| V2020 |
Frames, purchases |
2,001 |
1,942 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
915 |
857 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,435 |
1,390 |
$10K |
| V2750 |
Anti-reflective coating, per lens |
476 |
458 |
$0.00 |
| 2024F |
|
19 |
19 |
$0.00 |
| 92015 |
Determination of refractive state |
37 |
37 |
$0.00 |