| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,589 |
1,434 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
509 |
476 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
386 |
358 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,265 |
1,185 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,108 |
986 |
$7K |
| 92015 |
Determination of refractive state |
1,033 |
966 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
194 |
169 |
$877.76 |
| V2744 |
Tint, photochromatic, per lens |
14 |
12 |
$80.30 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
80 |
31 |
$0.00 |