| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
727 |
463 |
$24K |
| V2020 |
Frames, purchases |
774 |
762 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
772 |
769 |
$8K |
| 92015 |
Determination of refractive state |
946 |
943 |
$7K |
| 68761 |
|
283 |
159 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
264 |
264 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,145 |
1,144 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
18 |
13 |
$529.02 |