| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
310 |
285 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
754 |
380 |
$15K |
| V2020 |
Frames, purchases |
625 |
584 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
88 |
88 |
$9K |
| 92015 |
Determination of refractive state |
496 |
467 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
585 |
276 |
$3K |