| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,093 |
2,090 |
$144K |
| V2020 |
Frames, purchases |
4,271 |
4,250 |
$122K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,269 |
2,237 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,144 |
1,142 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
98 |
98 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
552 |
514 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
195 |
194 |
$4K |