| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,423 |
1,378 |
$60K |
| V2760 |
Scratch resistant coating, per lens |
1,311 |
1,272 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
335 |
326 |
$12K |
| 92015 |
Determination of refractive state |
1,320 |
1,274 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
160 |
156 |
$8K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
462 |
447 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
40 |
$4K |