| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,417 |
694 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
507 |
502 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
556 |
298 |
$10K |
| V2020 |
Frames, purchases |
704 |
651 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
237 |
111 |
$4K |
| 92015 |
Determination of refractive state |
716 |
708 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
40 |
40 |
$2K |