| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,171 |
2,157 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
705 |
391 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
555 |
555 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
375 |
336 |
$6K |
| 92002 |
|
179 |
179 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
788 |
398 |
$891.76 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
49 |
49 |
$864.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$480.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$476.22 |
| V2755 |
U-v lens, per lens |
132 |
65 |
$0.00 |