| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,010 |
1,920 |
$129K |
| V2020 |
Frames, purchases |
2,914 |
2,774 |
$116K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,545 |
1,484 |
$54K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
609 |
595 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
305 |
292 |
$27K |
| 92015 |
Determination of refractive state |
3,338 |
3,171 |
$19K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,056 |
1,012 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
102 |
97 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
63 |
62 |
$2K |