| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,393 |
1,378 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,143 |
1,082 |
$25K |
| V2020 |
Frames, purchases |
1,501 |
1,484 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
546 |
514 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,237 |
1,222 |
$7K |
| V2781 |
Progressive lens, per lens |
36 |
36 |
$2K |
| V2299 |
Specialty bifocal (by report) |
48 |
48 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
325 |
315 |
$0.00 |
| 92015 |
Determination of refractive state |
386 |
367 |
$0.00 |