| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
916 |
897 |
$34K |
| V2020 |
Frames, purchases |
1,902 |
1,855 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
766 |
756 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
794 |
770 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
896 |
864 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
47 |
46 |
$1K |
| 92015 |
Determination of refractive state |
1,932 |
1,894 |
$166.64 |