| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
489 |
480 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
556 |
549 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
347 |
345 |
$11K |
| V2020 |
Frames, purchases |
905 |
896 |
$6K |
| 92015 |
Determination of refractive state |
1,043 |
1,029 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
67 |
$4K |