| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,032 |
2,011 |
$84K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,631 |
1,615 |
$79K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
854 |
846 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
143 |
141 |
$14K |
| 92015 |
Determination of refractive state |
2,233 |
2,207 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
55 |
54 |
$4K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
369 |
365 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
29 |
29 |
$1K |
| 3072F |
|
15 |
15 |
$0.00 |