| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
332 |
326 |
$17K |
| V2020 |
Frames, purchases |
396 |
387 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
94 |
94 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
57 |
57 |
$3K |
| 92015 |
Determination of refractive state |
342 |
339 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
47 |
46 |
$460.00 |