| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,643 |
1,332 |
$23K |
| 92002 |
|
970 |
701 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
969 |
757 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
587 |
579 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
142 |
99 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
79 |
79 |
$738.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
162 |
127 |
$395.50 |
| 92015 |
Determination of refractive state |
572 |
551 |
$0.00 |
| 2023F |
|
12 |
12 |
$0.00 |