| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
325 |
264 |
$13K |
| V2020 |
Frames, purchases |
692 |
573 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
495 |
404 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
135 |
111 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
348 |
277 |
$3K |
| 92015 |
Determination of refractive state |
731 |
597 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
49 |
42 |
$537.12 |