| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,559 |
1,543 |
$135K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,142 |
1,140 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,032 |
1,031 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,208 |
1,197 |
$42K |
| V2020 |
Frames, purchases |
1,400 |
1,396 |
$30K |
| 92015 |
Determination of refractive state |
3,006 |
2,998 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
938 |
927 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
116 |
116 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
45 |
45 |
$2K |