| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
348 |
348 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
348 |
348 |
$16K |
| V2020 |
Frames, purchases |
330 |
330 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
25 |
25 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$630.00 |
| V2025 |
Deluxe frame |
14 |
14 |
$166.32 |