| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
236 |
230 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
69 |
67 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
78 |
77 |
$2K |
| 92015 |
Determination of refractive state |
408 |
358 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
234 |
226 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
132 |
131 |
$1K |