| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,896 |
1,881 |
$112K |
| V2020 |
Frames, purchases |
1,124 |
1,103 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
782 |
771 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
220 |
219 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
915 |
902 |
$5K |
| 92015 |
Determination of refractive state |
307 |
305 |
$4K |
| V2756 |
Eye glass case |
603 |
595 |
$633.96 |