| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,179 |
1,212 |
$73K |
| 92002 |
|
1,419 |
1,418 |
$57K |
| V2020 |
Frames, purchases |
2,438 |
2,196 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
997 |
982 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
555 |
541 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
151 |
123 |
$7K |
| S0500 |
Disposable contact lens, per lens |
89 |
89 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
21 |
13 |
$809.29 |
| V2744 |
Tint, photochromatic, per lens |
46 |
28 |
$235.00 |
| V2750 |
Anti-reflective coating, per lens |
99 |
56 |
$160.00 |
| V2799 |
Vision item or service, miscellaneous |
15 |
15 |
$135.00 |