| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
826 |
817 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
601 |
578 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
448 |
441 |
$8K |
| 92002 |
|
183 |
183 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
251 |
251 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
119 |
115 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
304 |
297 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
18 |
18 |
$591.18 |
| 92015 |
Determination of refractive state |
63 |
58 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
24 |
24 |
$0.00 |