| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,979 |
1,846 |
$80K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,187 |
1,098 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
341 |
335 |
$32K |
| V2760 |
Scratch resistant coating, per lens |
1,137 |
1,062 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
467 |
460 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
462 |
429 |
$15K |
| 92015 |
Determination of refractive state |
2,352 |
2,209 |
$13K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
768 |
732 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
109 |
104 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$775.33 |