| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,845 |
2,480 |
$115K |
| V2020 |
Frames, purchases |
3,177 |
2,804 |
$115K |
| 92014 |
|
937 |
919 |
$38K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
462 |
435 |
$16K |
| 92012 |
|
158 |
158 |
$6K |
| V2500 |
Contact lens, pmma, spherical, per lens |
89 |
72 |
$6K |
| V2750 |
Anti-reflective coating, per lens |
146 |
131 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
129 |
129 |
$4K |
| 92340 |
|
145 |
126 |
$3K |
| 92004 |
|
13 |
13 |
$545.00 |
| V2799 |
Vision item or service, miscellaneous |
137 |
115 |
$0.00 |