| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,968 |
2,014 |
$163K |
| V2020 |
Frames, purchases |
3,186 |
2,174 |
$116K |
| V2760 |
Scratch resistant coating, per lens |
1,993 |
819 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
468 |
457 |
$19K |
| V2750 |
Anti-reflective coating, per lens |
506 |
225 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
108 |
106 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,520 |
1,798 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
45 |
41 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
26 |
$1K |