| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,065 |
1,001 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
746 |
689 |
$19K |
| V2020 |
Frames, purchases |
1,182 |
1,095 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
342 |
324 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
808 |
735 |
$6K |
| 92015 |
Determination of refractive state |
738 |
664 |
$0.00 |