| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
723 |
701 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
249 |
225 |
$14K |
| 92015 |
Determination of refractive state |
1,843 |
1,735 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
222 |
219 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
88 |
85 |
$9K |
| V2760 |
Scratch resistant coating, per lens |
522 |
506 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$550.11 |