| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,305 |
3,209 |
$194K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,919 |
2,794 |
$186K |
| V2020 |
Frames, purchases |
3,953 |
3,839 |
$172K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,069 |
1,012 |
$94K |
| V2760 |
Scratch resistant coating, per lens |
2,701 |
2,616 |
$61K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
629 |
613 |
$29K |
| 92015 |
Determination of refractive state |
5,233 |
4,990 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
658 |
650 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
140 |
135 |
$7K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
52 |
51 |
$4K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
76 |
70 |
$690.00 |
| 92370 |
|
88 |
86 |
$621.18 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$464.62 |
| 2023F |
|
451 |
450 |
$0.00 |