| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,873 |
1,220 |
$66K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,461 |
1,420 |
$64K |
| V2020 |
Frames, purchases |
1,936 |
1,637 |
$46K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,407 |
840 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
149 |
144 |
$7K |
| 92015 |
Determination of refractive state |
854 |
830 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
62 |
26 |
$2K |