| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
210 |
154 |
$7K |
| V2020 |
Frames, purchases |
449 |
337 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
303 |
230 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
88 |
55 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
280 |
203 |
$2K |
| 92015 |
Determination of refractive state |
491 |
351 |
$2K |
| V2744 |
Tint, photochromatic, per lens |
38 |
26 |
$225.00 |