| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,051 |
2,321 |
$108K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,341 |
1,400 |
$90K |
| 92002 |
|
1,918 |
1,884 |
$79K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,689 |
1,657 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
463 |
462 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
130 |
65 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
30 |
15 |
$445.00 |