| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,364 |
1,329 |
$52K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
754 |
746 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
597 |
587 |
$27K |
| V2760 |
Scratch resistant coating, per lens |
1,253 |
1,223 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
411 |
400 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
87 |
86 |
$8K |
| 92015 |
Determination of refractive state |
841 |
818 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
60 |
59 |
$2K |
| 3072F |
|
13 |
13 |
$0.00 |