| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,164 |
1,861 |
$145K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,058 |
2,006 |
$81K |
| 92002 |
|
820 |
790 |
$32K |
| V2020 |
Frames, purchases |
1,992 |
1,892 |
$31K |
| V2025 |
Deluxe frame |
310 |
292 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
28 |
27 |
$2K |
| V2599 |
Contact lens, other type |
12 |
12 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
22 |
21 |
$20.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
32 |
13 |
$0.00 |