| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
491 |
400 |
$20K |
| V2020 |
Frames, purchases |
1,048 |
878 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
785 |
653 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
368 |
298 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
643 |
535 |
$7K |
| 92015 |
Determination of refractive state |
1,016 |
829 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
170 |
135 |
$1K |