| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,258 |
3,876 |
$162K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,445 |
1,914 |
$105K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,143 |
1,779 |
$74K |
| V2760 |
Scratch resistant coating, per lens |
4,893 |
3,853 |
$67K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,026 |
1,653 |
$61K |
| 92015 |
Determination of refractive state |
6,202 |
5,189 |
$30K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
313 |
280 |
$17K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
450 |
232 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
329 |
214 |
$8K |
| 92002 |
|
159 |
153 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
29 |
25 |
$2K |
| 92250 |
|
128 |
79 |
$1K |
| V2715 |
Prism, per lens |
12 |
12 |
$188.32 |