| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,865 |
1,662 |
$104K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,706 |
1,648 |
$74K |
| V2020 |
Frames, purchases |
2,482 |
1,880 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
649 |
640 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,140 |
506 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
752 |
517 |
$25K |
| 92015 |
Determination of refractive state |
1,335 |
1,284 |
$6K |
| V2750 |
Anti-reflective coating, per lens |
23 |
12 |
$363.00 |