| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
950 |
930 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
332 |
315 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
341 |
336 |
$27K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
776 |
760 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
390 |
385 |
$19K |
| 92015 |
Determination of refractive state |
455 |
435 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
98 |
88 |
$3K |