| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
538 |
526 |
$39K |
| V2020 |
Frames, purchases |
509 |
502 |
$14K |
| 92015 |
Determination of refractive state |
971 |
942 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
125 |
120 |
$9K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
156 |
155 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
243 |
241 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
83 |
83 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
301 |
298 |
$3K |