| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
919 |
889 |
$34K |
| V2755 |
U-v lens, per lens |
722 |
708 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
155 |
152 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
73 |
69 |
$7K |
| 92015 |
Determination of refractive state |
445 |
367 |
$7K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
293 |
286 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
26 |
26 |
$3K |