| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
656 |
630 |
$30K |
| V2760 |
Scratch resistant coating, per lens |
638 |
600 |
$12K |
| 92015 |
Determination of refractive state |
1,341 |
1,180 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
99 |
95 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
66 |
65 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
194 |
191 |
$2K |