| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
957 |
907 |
$37K |
| V2020 |
Frames, purchases |
1,380 |
1,319 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,027 |
987 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
748 |
714 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
78 |
75 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20 |
20 |
$400.00 |
| 92015 |
Determination of refractive state |
1,361 |
1,287 |
$61.57 |