| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,837 |
3,009 |
$65K |
| V2020 |
Frames, purchases |
3,747 |
3,173 |
$64K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,488 |
1,250 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,167 |
2,505 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
781 |
633 |
$31K |
| 92015 |
Determination of refractive state |
2,398 |
1,985 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
691 |
548 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
448 |
376 |
$7K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
128 |
117 |
$2K |