| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
268 |
254 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
81 |
78 |
$5K |
| V2020 |
Frames, purchases |
219 |
202 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
140 |
132 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
34 |
30 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$1K |
| V2702 |
Deluxe lens feature |
30 |
29 |
$34.00 |