| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
569 |
546 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
364 |
363 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
273 |
273 |
$13K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
245 |
236 |
$10K |
| V2020 |
Frames, purchases |
713 |
690 |
$10K |
| 92015 |
Determination of refractive state |
439 |
438 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
72 |
70 |
$2K |
| V2202 |
Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens |
15 |
15 |
$750.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$720.00 |