| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
803 |
767 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
353 |
344 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
190 |
185 |
$19K |
| 92015 |
Determination of refractive state |
1,213 |
1,111 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
141 |
76 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
24 |
12 |
$672.00 |