| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
1,593 |
1,583 |
$64K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,104 |
2,081 |
$42K |
| V2020 |
Frames, purchases |
498 |
491 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,126 |
1,115 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
795 |
786 |
$11K |
| V2750 |
Anti-reflective coating, per lens |
427 |
422 |
$6K |
| 92015 |
Determination of refractive state |
496 |
363 |
$5K |
| V2799 |
Vision item or service, miscellaneous |
736 |
661 |
$5K |
| 92060 |
|
109 |
81 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
233 |
232 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
31 |
27 |
$3K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
63 |
62 |
$0.00 |
| 99072 |
|
45 |
38 |
$0.00 |