| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
908 |
893 |
$68K |
| V2020 |
Frames, purchases |
992 |
974 |
$64K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
493 |
485 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
758 |
743 |
$31K |
| 92015 |
Determination of refractive state |
931 |
919 |
$22K |
| 92250 |
|
180 |
173 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
101 |
101 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
22 |
22 |
$26.88 |