| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
737 |
700 |
$60K |
| V2020 |
Frames, purchases |
1,199 |
1,152 |
$58K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,115 |
1,068 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
628 |
601 |
$24K |
| 92015 |
Determination of refractive state |
1,127 |
1,081 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
47 |
46 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
52 |
52 |
$2K |