| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,371 |
1,319 |
$93K |
| V2020 |
Frames, purchases |
935 |
892 |
$69K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
425 |
408 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
253 |
244 |
$33K |
| 92015 |
Determination of refractive state |
1,435 |
1,380 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
270 |
255 |
$16K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
68 |
63 |
$4K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
55 |
51 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
42 |
37 |
$1K |