| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,193 |
1,068 |
$43K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
488 |
483 |
$19K |
| V2020 |
Frames, purchases |
1,627 |
1,588 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
282 |
139 |
$6K |
| 92002 |
|
137 |
136 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
89 |
89 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
67 |
66 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,156 |
1,543 |
$750.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
13 |
$743.08 |