| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
147 |
140 |
$14K |
| V2020 |
Frames, purchases |
146 |
143 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
117 |
114 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
41 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
39 |
$2K |
| 92015 |
Determination of refractive state |
12 |
12 |
$209.55 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$0.00 |