| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
762 |
733 |
$64K |
| V2020 |
Frames, purchases |
1,230 |
1,135 |
$46K |
| 92015 |
Determination of refractive state |
1,687 |
1,606 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
171 |
163 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
232 |
227 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
54 |
53 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
59 |
57 |
$794.24 |