| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
10,352 |
8,802 |
$588K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,983 |
4,393 |
$173K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,834 |
3,210 |
$112K |
| V2020 |
Frames, purchases |
9,616 |
8,295 |
$79K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
714 |
629 |
$28K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
204 |
170 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
44 |
43 |
$2K |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
30 |
27 |
$2K |
| 92015 |
Determination of refractive state |
62 |
61 |
$0.00 |