| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
477 |
471 |
$43K |
| V2020 |
Frames, purchases |
974 |
940 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
145 |
139 |
$15K |
| 92015 |
Determination of refractive state |
1,137 |
1,103 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
674 |
647 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
110 |
103 |
$2K |
| 92250 |
|
40 |
39 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
61 |
$1K |