| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,661 |
2,442 |
$88K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,358 |
1,268 |
$69K |
| V2755 |
U-v lens, per lens |
1,232 |
1,143 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
203 |
181 |
$14K |
| 92015 |
Determination of refractive state |
235 |
235 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
51 |
51 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
16 |
16 |
$928.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$624.00 |