| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
788 |
755 |
$38K |
| V2020 |
Frames, purchases |
1,025 |
976 |
$36K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
436 |
427 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
129 |
125 |
$12K |
| 92015 |
Determination of refractive state |
1,165 |
1,112 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
111 |
109 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
22 |
22 |
$962.28 |