| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,557 |
1,529 |
$39K |
| V2020 |
Frames, purchases |
1,448 |
1,427 |
$38K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
885 |
857 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
753 |
750 |
$30K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,645 |
1,615 |
$13K |
| 92250 |
|
26 |
26 |
$0.00 |
| 92015 |
Determination of refractive state |
1,724 |
1,688 |
$0.00 |