| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
622 |
537 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
994 |
761 |
$18K |
| V2020 |
Frames, purchases |
874 |
723 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
589 |
447 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
174 |
146 |
$7K |
| 92015 |
Determination of refractive state |
1,000 |
847 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
296 |
218 |
$3K |