| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,436 |
1,381 |
$24K |
| V2020 |
Frames, purchases |
1,625 |
1,561 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
965 |
893 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
831 |
762 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,148 |
1,107 |
$8K |
| V2781 |
Progressive lens, per lens |
24 |
24 |
$660.00 |
| V2299 |
Specialty bifocal (by report) |
24 |
24 |
$452.40 |
| 92015 |
Determination of refractive state |
772 |
717 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
284 |
263 |
$0.00 |