| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,709 |
4,692 |
$158K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,327 |
2,316 |
$77K |
| V2020 |
Frames, purchases |
6,482 |
6,291 |
$76K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,492 |
890 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
585 |
585 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
10,877 |
5,634 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
628 |
613 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
294 |
169 |
$8K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
13 |
$360.00 |
| V2755 |
U-v lens, per lens |
202 |
101 |
$0.00 |