| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
929 |
876 |
$43K |
| V2020 |
Frames, purchases |
1,276 |
1,226 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
513 |
491 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,315 |
1,252 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,011 |
960 |
$11K |
| 92015 |
Determination of refractive state |
1,476 |
1,399 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
370 |
351 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
98 |
92 |
$2K |