| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
697 |
682 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
409 |
392 |
$29K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
631 |
626 |
$19K |
| 92015 |
Determination of refractive state |
895 |
878 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
213 |
195 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
37 |
36 |
$2K |