| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,996 |
2,929 |
$48K |
| V2199 |
Not otherwise classified, single vision lens |
1,649 |
821 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
313 |
307 |
$12K |
| V2299 |
Specialty bifocal (by report) |
1,245 |
616 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
504 |
277 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
292 |
149 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
172 |
86 |
$369.72 |
| V2760 |
Scratch resistant coating, per lens |
101 |
50 |
$350.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
180 |
90 |
$233.48 |
| V2799 |
Vision item or service, miscellaneous |
56 |
41 |
$160.00 |
| V2750 |
Anti-reflective coating, per lens |
26 |
12 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,838 |
1,411 |
$0.00 |
| V2755 |
U-v lens, per lens |
2,976 |
1,478 |
$0.00 |