| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
666 |
644 |
$27K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
218 |
217 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
128 |
125 |
$6K |
| 92015 |
Determination of refractive state |
1,103 |
988 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
164 |
162 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
76 |
64 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
25 |
24 |
$1K |