| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,121 |
4,005 |
$180K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,585 |
2,945 |
$164K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,674 |
1,624 |
$114K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,146 |
1,112 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
589 |
584 |
$57K |
| V2760 |
Scratch resistant coating, per lens |
2,774 |
2,679 |
$55K |
| 92015 |
Determination of refractive state |
3,638 |
3,548 |
$21K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
25 |
25 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
26 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
13 |
13 |
$130.00 |
| 3072F |
|
14 |
14 |
$0.00 |