| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,275 |
2,251 |
$37K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
806 |
797 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,129 |
1,119 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,289 |
1,276 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
133 |
133 |
$5K |
| 92015 |
Determination of refractive state |
1,414 |
1,385 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
149 |
148 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$500.10 |