| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
600 |
523 |
$26K |
| V2020 |
Frames, purchases |
1,144 |
992 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
440 |
385 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
772 |
672 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
789 |
667 |
$7K |
| 92015 |
Determination of refractive state |
1,146 |
993 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
52 |
$384.58 |