| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,382 |
2,143 |
$138K |
| V2199 |
Not otherwise classified, single vision lens |
2,055 |
1,844 |
$129K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,641 |
1,517 |
$106K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
574 |
517 |
$51K |
| 92015 |
Determination of refractive state |
3,729 |
3,426 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
335 |
304 |
$35K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
731 |
685 |
$34K |
| 92002 |
|
140 |
132 |
$9K |