| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
749 |
731 |
$50K |
| V2020 |
Frames, purchases |
1,009 |
979 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
243 |
235 |
$23K |
| 92015 |
Determination of refractive state |
2,377 |
2,334 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
224 |
137 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
291 |
142 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
21 |
12 |
$598.50 |