| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,180 |
2,129 |
$47K |
| V2020 |
Frames, purchases |
2,605 |
2,546 |
$44K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,371 |
1,337 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
121 |
121 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
96 |
96 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
43 |
43 |
$1K |