| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,091 |
1,667 |
$138K |
| V2020 |
Frames, purchases |
3,297 |
2,230 |
$108K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,977 |
1,916 |
$83K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
609 |
598 |
$25K |
| V2750 |
Anti-reflective coating, per lens |
841 |
363 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,860 |
1,928 |
$15K |