| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
702 |
687 |
$11K |
| V2020 |
Frames, purchases |
807 |
787 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
387 |
366 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
354 |
337 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
548 |
536 |
$3K |
| 92015 |
Determination of refractive state |
241 |
224 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
65 |
60 |
$0.00 |