| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,468 |
1,359 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
929 |
712 |
$35K |
| V2020 |
Frames, purchases |
2,021 |
1,572 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
666 |
559 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,572 |
1,144 |
$22K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
170 |
81 |
$3K |
| 92015 |
Determination of refractive state |
406 |
401 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
162 |
87 |
$1K |