| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,239 |
1,084 |
$101K |
| V2020 |
Frames, purchases |
1,762 |
1,516 |
$94K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,772 |
1,530 |
$34K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
367 |
340 |
$32K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,751 |
1,511 |
$17K |
| 92015 |
Determination of refractive state |
1,653 |
1,451 |
$1K |