| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,265 |
2,082 |
$138K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,236 |
1,141 |
$112K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,041 |
1,797 |
$88K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,071 |
1,001 |
$82K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,127 |
2,008 |
$60K |
| 92015 |
Determination of refractive state |
2,809 |
2,613 |
$44K |
| 92081 |
|
181 |
150 |
$2K |