| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,220 |
5,390 |
$225K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,713 |
2,460 |
$141K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,148 |
1,931 |
$106K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,091 |
1,862 |
$77K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,704 |
1,505 |
$36K |
| 92015 |
Determination of refractive state |
6,812 |
6,113 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
427 |
389 |
$36K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
366 |
335 |
$16K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,481 |
1,371 |
$13K |
| 92002 |
|
18 |
12 |
$604.56 |