| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
532 |
522 |
$30K |
| 92015 |
Determination of refractive state |
876 |
833 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
220 |
203 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
527 |
506 |
$10K |
| V2020 |
Frames, purchases |
1,337 |
1,283 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,250 |
1,189 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
713 |
422 |
$3K |