| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
780 |
756 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
315 |
306 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
270 |
266 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
57 |
$6K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
405 |
394 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
71 |
71 |
$4K |
| 92015 |
Determination of refractive state |
572 |
556 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
76 |
76 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
96 |
95 |
$2K |