| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,678 |
1,605 |
$109K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
981 |
962 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
725 |
682 |
$66K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,338 |
1,278 |
$35K |
| 92015 |
Determination of refractive state |
1,737 |
1,683 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
693 |
655 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
341 |
320 |
$9K |
| 92250 |
|
28 |
26 |
$751.57 |