| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,898 |
2,681 |
$81K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,248 |
1,175 |
$68K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,162 |
1,994 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
821 |
779 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
296 |
285 |
$21K |
| 92015 |
Determination of refractive state |
2,118 |
1,991 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
573 |
537 |
$6K |