| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
975 |
941 |
$75K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
843 |
819 |
$63K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
932 |
899 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
104 |
88 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,009 |
977 |
$2K |
| 92015 |
Determination of refractive state |
1,071 |
1,040 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
928 |
895 |
$2K |
| 92310 |
|
263 |
253 |
$291.40 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
14 |
$0.00 |
| 2023F |
|
22 |
22 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
560 |
535 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
19 |
18 |
$0.00 |