| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
539 |
504 |
$33K |
| V2020 |
Frames, purchases |
771 |
724 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
323 |
290 |
$12K |
| 92015 |
Determination of refractive state |
980 |
926 |
$10K |
| V2755 |
U-v lens, per lens |
593 |
566 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
92 |
87 |
$5K |