| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
476 |
392 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
232 |
231 |
$10K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
155 |
121 |
$5K |
| V2020 |
Frames, purchases |
471 |
388 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
52 |
52 |
$3K |
| 92015 |
Determination of refractive state |
375 |
374 |
$2K |