| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,695 |
2,611 |
$114K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,681 |
1,631 |
$78K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,305 |
1,229 |
$47K |
| 92015 |
Determination of refractive state |
3,959 |
3,639 |
$21K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,900 |
1,860 |
$18K |
| 92002 |
|
105 |
103 |
$6K |
| 92370 |
|
279 |
274 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$608.60 |