| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,993 |
1,888 |
$82K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
941 |
901 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
885 |
557 |
$21K |
| V2760 |
Scratch resistant coating, per lens |
1,496 |
734 |
$16K |
| 92015 |
Determination of refractive state |
1,634 |
1,543 |
$9K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,491 |
829 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
254 |
197 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
189 |
173 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
17 |
16 |
$1K |
| 2026F |
|
18 |
15 |
$0.00 |