| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,347 |
1,319 |
$79K |
| V2020 |
Frames, purchases |
1,563 |
1,533 |
$69K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,031 |
1,004 |
$67K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
383 |
375 |
$35K |
| V2760 |
Scratch resistant coating, per lens |
1,312 |
1,279 |
$29K |
| 92015 |
Determination of refractive state |
2,077 |
2,022 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
202 |
199 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
78 |
78 |
$4K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
13 |
12 |
$745.38 |
| 92370 |
|
14 |
13 |
$99.96 |
| 2023F |
|
145 |
143 |
$0.00 |