| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,098 |
2,049 |
$132K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,660 |
1,629 |
$127K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,542 |
1,512 |
$74K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,020 |
1,981 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
463 |
452 |
$42K |
| 92015 |
Determination of refractive state |
2,260 |
2,209 |
$38K |
| V2715 |
Prism, per lens |
25 |
25 |
$340.00 |