| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,341 |
1,340 |
$87K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,838 |
1,835 |
$80K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,205 |
1,204 |
$52K |
| V2020 |
Frames, purchases |
1,783 |
1,781 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
888 |
876 |
$31K |
| 92015 |
Determination of refractive state |
3,061 |
3,058 |
$27K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
279 |
158 |
$6K |