| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
578 |
567 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
515 |
503 |
$21K |
| V2020 |
Frames, purchases |
900 |
874 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
188 |
187 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
113 |
109 |
$4K |
| 92015 |
Determination of refractive state |
94 |
94 |
$3K |
| V2025 |
Deluxe frame |
160 |
155 |
$2K |