| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,706 |
1,523 |
$94K |
| V2020 |
Frames, purchases |
2,824 |
2,408 |
$70K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
858 |
737 |
$39K |
| 92015 |
Determination of refractive state |
1,783 |
1,524 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
396 |
347 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
585 |
501 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
73 |
63 |
$3K |