| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,509 |
1,158 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
544 |
544 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
404 |
404 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
788 |
583 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,075 |
708 |
$13K |
| 92015 |
Determination of refractive state |
1,114 |
1,114 |
$0.00 |