| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
9,212 |
2,741 |
$250K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,342 |
5,228 |
$228K |
| V2020 |
Frames, purchases |
5,183 |
3,161 |
$196K |
| V2500 |
Contact lens, pmma, spherical, per lens |
255 |
246 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
45 |
45 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,812 |
1,840 |
$1K |