| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
878 |
747 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
295 |
254 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
274 |
246 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
703 |
635 |
$7K |
| 92015 |
Determination of refractive state |
704 |
631 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
526 |
435 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
49 |
39 |
$237.51 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
48 |
17 |
$0.00 |