| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
868 |
851 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
333 |
327 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
227 |
226 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
77 |
75 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$665.32 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
17 |
17 |
$659.26 |
| 92015 |
Determination of refractive state |
447 |
444 |
$587.22 |