| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
765 |
737 |
$47K |
| V2020 |
Frames, purchases |
815 |
776 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
453 |
440 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
251 |
251 |
$9K |
| 92015 |
Determination of refractive state |
1,832 |
1,735 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
328 |
192 |
$5K |