| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,163 |
3,047 |
$232K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,393 |
1,337 |
$138K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
937 |
899 |
$110K |
| 92015 |
Determination of refractive state |
5,116 |
4,865 |
$80K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,051 |
1,008 |
$60K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
179 |
178 |
$7K |
| V2760 |
Scratch resistant coating, per lens |
167 |
160 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
16 |
$962.87 |