| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,982 |
1,890 |
$60K |
| V2020 |
Frames, purchases |
510 |
480 |
$28K |
| 92015 |
Determination of refractive state |
337 |
314 |
$3K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
237 |
223 |
$475.40 |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
14 |
14 |
$219.24 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
40 |
34 |
$40.00 |