| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
195 |
189 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
134 |
132 |
$11K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
186 |
183 |
$4K |
| 92015 |
Determination of refractive state |
239 |
235 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
16 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
44 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$1K |