| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,682 |
1,639 |
$75K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,169 |
1,146 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
278 |
275 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
311 |
302 |
$13K |
| 92015 |
Determination of refractive state |
1,997 |
1,952 |
$12K |
| 92002 |
|
185 |
183 |
$10K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
537 |
523 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
27 |
$1K |