| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
472 |
472 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
306 |
306 |
$32K |
| V2020 |
Frames, purchases |
532 |
532 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
264 |
264 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
423 |
423 |
$17K |
| 92015 |
Determination of refractive state |
634 |
634 |
$10K |