| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,409 |
1,237 |
$81K |
| V2199 |
Not otherwise classified, single vision lens |
632 |
551 |
$40K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
398 |
369 |
$34K |
| 92015 |
Determination of refractive state |
1,474 |
1,364 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
89 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
236 |
199 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
67 |
65 |
$5K |
| 92002 |
|
13 |
13 |
$893.75 |