| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,694 |
1,667 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,187 |
1,172 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
636 |
634 |
$23K |
| 92002 |
|
475 |
471 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
284 |
282 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
772 |
759 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
134 |
133 |
$5K |
| 92015 |
Determination of refractive state |
1,860 |
1,848 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
47 |
47 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
64 |
63 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
24 |
24 |
$0.00 |