| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
797 |
764 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
275 |
271 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
149 |
137 |
$6K |
| 92015 |
Determination of refractive state |
246 |
238 |
$5K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
191 |
186 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
101 |
98 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |