| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,122 |
1,105 |
$27K |
| V2020 |
Frames, purchases |
1,382 |
1,364 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
447 |
443 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
275 |
273 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
813 |
798 |
$11K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
138 |
138 |
$5K |
| 92015 |
Determination of refractive state |
731 |
725 |
$0.00 |
| 99072 |
|
132 |
126 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
18 |
17 |
$0.00 |