| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
894 |
607 |
$43K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
755 |
479 |
$34K |
| V2020 |
Frames, purchases |
1,024 |
694 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
180 |
179 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
70 |
70 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
118 |
116 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
29 |
13 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
29 |
12 |
$0.00 |