| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
473 |
415 |
$21K |
| V2020 |
Frames, purchases |
718 |
612 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
476 |
413 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
138 |
108 |
$5K |
| 92015 |
Determination of refractive state |
861 |
746 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
451 |
381 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
42 |
$422.77 |