| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,406 |
682 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
570 |
559 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
706 |
403 |
$12K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
258 |
113 |
$12K |
| V2020 |
Frames, purchases |
931 |
863 |
$7K |
| 92015 |
Determination of refractive state |
1,053 |
1,033 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
79 |
79 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
129 |
57 |
$2K |