| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,234 |
3,071 |
$126K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,304 |
1,254 |
$77K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
991 |
941 |
$34K |
| 92015 |
Determination of refractive state |
4,015 |
3,822 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
378 |
372 |
$18K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,262 |
1,203 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
56 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
362 |
344 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$1K |
| V2715 |
Prism, per lens |
80 |
78 |
$1K |