| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
373 |
366 |
$22K |
| V2020 |
Frames, purchases |
346 |
340 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
68 |
68 |
$4K |
| 92015 |
Determination of refractive state |
587 |
585 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
61 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
33 |
32 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$100.00 |
| 2033F |
|
29 |
29 |
$0.00 |