| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,476 |
834 |
$73K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,032 |
621 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
533 |
519 |
$23K |
| V2020 |
Frames, purchases |
1,393 |
868 |
$14K |
| 92250 |
|
112 |
106 |
$5K |
| 92015 |
Determination of refractive state |
674 |
658 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
44 |
40 |
$2K |