| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,693 |
1,672 |
$69K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
815 |
806 |
$56K |
| V2760 |
Scratch resistant coating, per lens |
1,604 |
1,591 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
404 |
403 |
$15K |
| 92015 |
Determination of refractive state |
1,768 |
1,755 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
51 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
31 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$500.10 |
| 2026F |
|
41 |
40 |
$0.00 |
| 2033F |
|
42 |
42 |
$0.00 |