| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,770 |
1,665 |
$106K |
| V2199 |
Not otherwise classified, single vision lens |
1,610 |
1,503 |
$88K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
681 |
655 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
466 |
441 |
$39K |
| 92015 |
Determination of refractive state |
2,896 |
2,651 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
199 |
192 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
375 |
349 |
$10K |
| 92002 |
|
15 |
13 |
$801.68 |