| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,910 |
933 |
$69K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,077 |
1,043 |
$56K |
| V2020 |
Frames, purchases |
1,396 |
1,150 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,137 |
1,099 |
$48K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
594 |
571 |
$19K |
| 92134 |
|
184 |
183 |
$6K |
| 92083 |
|
95 |
95 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,349 |
539 |
$5K |
| 92015 |
Determination of refractive state |
642 |
630 |
$4K |
| 92133 |
|
39 |
39 |
$1K |
| V2025 |
Deluxe frame |
87 |
87 |
$1K |
| 92020 |
|
37 |
37 |
$648.00 |