| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,238 |
1,196 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
782 |
758 |
$40K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,063 |
1,020 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
394 |
392 |
$17K |
| 92015 |
Determination of refractive state |
386 |
364 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
29 |
$231.50 |