| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
608 |
529 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
968 |
411 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
440 |
439 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
249 |
248 |
$10K |
| V2760 |
Scratch resistant coating, per lens |
300 |
137 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
404 |
161 |
$1K |