| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
945 |
619 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
522 |
515 |
$23K |
| V2020 |
Frames, purchases |
1,461 |
1,149 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
354 |
350 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
425 |
312 |
$16K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
153 |
115 |
$6K |