| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
839 |
824 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
812 |
513 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
237 |
236 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
203 |
199 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
259 |
255 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
989 |
497 |
$440.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$240.00 |
| 92015 |
Determination of refractive state |
40 |
40 |
$0.00 |