| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,376 |
1,246 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
588 |
569 |
$21K |
| V2020 |
Frames, purchases |
1,603 |
1,589 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
446 |
439 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,167 |
1,099 |
$964.00 |
| V2755 |
U-v lens, per lens |
452 |
224 |
$0.00 |