| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,937 |
5,768 |
$168K |
| V2020 |
Frames, purchases |
8,492 |
8,366 |
$105K |
| 92002 |
|
2,588 |
2,588 |
$71K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,868 |
1,867 |
$70K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,560 |
1,305 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,399 |
753 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,201 |
2,607 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
132 |
132 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
138 |
138 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
191 |
98 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
90 |
45 |
$575.12 |
| 92341 |
|
12 |
12 |
$200.00 |
| V2755 |
U-v lens, per lens |
6,848 |
3,400 |
$0.00 |