| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
538 |
514 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
181 |
174 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
214 |
204 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
26 |
26 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
89 |
83 |
$832.00 |
| 92015 |
Determination of refractive state |
601 |
588 |
$20.83 |