| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
677 |
566 |
$48K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
460 |
455 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
192 |
66 |
$5K |
| 92015 |
Determination of refractive state |
802 |
801 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
27 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
243 |
79 |
$1K |