| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
960 |
931 |
$72K |
| V2020 |
Frames, purchases |
2,359 |
2,314 |
$68K |
| 92015 |
Determination of refractive state |
3,525 |
3,416 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
585 |
521 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
263 |
260 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
532 |
315 |
$9K |
| V2744 |
Tint, photochromatic, per lens |
40 |
39 |
$611.76 |