| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,097 |
1,013 |
$83K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,457 |
1,437 |
$60K |
| V2020 |
Frames, purchases |
1,722 |
1,125 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
172 |
171 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,757 |
868 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
15 |
13 |
$150.00 |