| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
367 |
367 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
309 |
307 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
234 |
189 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
187 |
187 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
88 |
88 |
$6K |
| 92015 |
Determination of refractive state |
573 |
572 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
381 |
381 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
179 |
179 |
$2K |