| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,576 |
1,575 |
$54K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,463 |
874 |
$24K |
| V2020 |
Frames, purchases |
1,902 |
1,860 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
254 |
124 |
$5K |
| 92015 |
Determination of refractive state |
1,098 |
1,092 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,135 |
1,107 |
$1K |