| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
449 |
433 |
$44K |
| V2020 |
Frames, purchases |
718 |
702 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
410 |
395 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
680 |
667 |
$30K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
721 |
708 |
$17K |
| 92015 |
Determination of refractive state |
916 |
886 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$0.00 |