| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
740 |
586 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
142 |
114 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
364 |
281 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
244 |
159 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
18 |
13 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
14 |
14 |
$211.00 |