| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
976 |
947 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
287 |
274 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
384 |
361 |
$22K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
941 |
917 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
831 |
628 |
$18K |
| 92015 |
Determination of refractive state |
1,644 |
1,592 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
122 |
122 |
$9K |
| 92002 |
|
156 |
155 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
63 |
54 |
$1K |