| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,180 |
2,734 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,515 |
1,510 |
$48K |
| V2020 |
Frames, purchases |
3,436 |
3,419 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
846 |
846 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
964 |
501 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,632 |
815 |
$0.00 |
| V2755 |
U-v lens, per lens |
1,038 |
519 |
$0.00 |