| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14,202 |
4,599 |
$389K |
| V2020 |
Frames, purchases |
8,147 |
5,501 |
$343K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,102 |
5,917 |
$263K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,128 |
1,122 |
$48K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
430 |
212 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
222 |
63 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,612 |
2,577 |
$5K |
| V2299 |
Specialty bifocal (by report) |
24 |
12 |
$846.68 |
| V2781 |
Progressive lens, per lens |
24 |
12 |
$700.00 |