| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,160 |
998 |
$62K |
| V2020 |
Frames, purchases |
1,615 |
1,390 |
$60K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
469 |
421 |
$27K |
| 92015 |
Determination of refractive state |
1,526 |
1,296 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
81 |
77 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
221 |
202 |
$409.00 |