| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,373 |
1,182 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
404 |
379 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,002 |
758 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
410 |
318 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,125 |
548 |
$12K |
| 92015 |
Determination of refractive state |
1,758 |
1,568 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
102 |
55 |
$628.75 |