| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2205 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
593 |
554 |
$64K |
| V2020 |
Frames, purchases |
2,227 |
2,097 |
$62K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
348 |
346 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
152 |
151 |
$19K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
198 |
187 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
66 |
29 |
$0.00 |