| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
250 |
245 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
176 |
172 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
208 |
204 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
134 |
129 |
$15K |
| 92015 |
Determination of refractive state |
723 |
716 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
79 |
77 |
$4K |