| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,925 |
2,220 |
$171K |
| V2020 |
Frames, purchases |
3,356 |
2,692 |
$103K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,472 |
2,415 |
$99K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
794 |
791 |
$32K |
| V2744 |
Tint, photochromatic, per lens |
471 |
286 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
146 |
144 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,960 |
953 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
60 |
37 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
84 |
29 |
$2K |
| V2299 |
Specialty bifocal (by report) |
53 |
30 |
$2K |
| V2781 |
Progressive lens, per lens |
73 |
43 |
$2K |
| V2025 |
Deluxe frame |
35 |
35 |
$415.80 |