| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,277 |
1,250 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
661 |
646 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
179 |
179 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
151 |
148 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
124 |
124 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
167 |
164 |
$1K |