| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,651 |
1,619 |
$91K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
405 |
404 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
296 |
295 |
$35K |
| 92015 |
Determination of refractive state |
1,101 |
1,097 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
136 |
112 |
$961.60 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
15 |
$101.08 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
282 |
167 |
$0.00 |