| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,401 |
1,357 |
$89K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,374 |
1,369 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
333 |
332 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
296 |
290 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
257 |
256 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
328 |
313 |
$7K |
| 92015 |
Determination of refractive state |
14 |
14 |
$0.00 |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
103 |
76 |
$0.00 |