| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,286 |
1,263 |
$82K |
| V2020 |
Frames, purchases |
1,036 |
986 |
$26K |
| V2110 |
Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens |
834 |
417 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
159 |
155 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
106 |
97 |
$2K |
| V2756 |
Eye glass case |
514 |
505 |
$536.76 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
84 |
82 |
$122.08 |
| 92015 |
Determination of refractive state |
59 |
57 |
$0.00 |