| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,550 |
6,060 |
$270K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,498 |
3,271 |
$226K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,140 |
1,092 |
$106K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,094 |
1,634 |
$76K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,762 |
1,445 |
$63K |
| 92015 |
Determination of refractive state |
6,564 |
6,160 |
$37K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
3,880 |
3,580 |
$35K |
| 92250 |
|
203 |
189 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
117 |
111 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
129 |
61 |
$3K |
| 92285 |
|
12 |
12 |
$341.00 |