| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
666 |
641 |
$25K |
| V2020 |
Frames, purchases |
1,140 |
1,085 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
253 |
247 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
753 |
707 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
144 |
137 |
$2K |
| 92310 |
|
42 |
42 |
$2K |
| 92015 |
Determination of refractive state |
1,224 |
1,189 |
$1K |