| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,412 |
1,328 |
$124K |
| V2020 |
Frames, purchases |
930 |
846 |
$54K |
| V2199 |
Not otherwise classified, single vision lens |
614 |
560 |
$37K |
| 92015 |
Determination of refractive state |
1,936 |
1,832 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
23 |
22 |
$3K |
| 92250 |
|
52 |
49 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
27 |
$2K |
| 92370 |
|
12 |
12 |
$371.68 |