| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
597 |
539 |
$26K |
| V2020 |
Frames, purchases |
935 |
786 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
327 |
287 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
540 |
458 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
662 |
540 |
$5K |
| 92015 |
Determination of refractive state |
1,048 |
926 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
12 |
$144.00 |