| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,621 |
1,615 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,410 |
1,405 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,083 |
1,079 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
880 |
876 |
$11K |
| 92002 |
|
330 |
329 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
161 |
161 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
171 |
169 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
99 |
99 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
77 |
76 |
$657.30 |