| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
923 |
448 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
322 |
321 |
$14K |
| V2020 |
Frames, purchases |
851 |
833 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
133 |
133 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
35 |
34 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,638 |
805 |
$600.00 |