| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
244 |
216 |
$11K |
| V2020 |
Frames, purchases |
403 |
359 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
160 |
147 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
83 |
62 |
$3K |
| 92015 |
Determination of refractive state |
628 |
520 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
126 |
112 |
$1K |