| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
589 |
566 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
179 |
173 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
225 |
217 |
$7K |
| 92015 |
Determination of refractive state |
561 |
535 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
41 |
39 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
14 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
121 |
116 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
13 |
$408.20 |