| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,417 |
1,375 |
$178K |
| V2020 |
Frames, purchases |
1,310 |
1,299 |
$95K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,130 |
1,119 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
252 |
245 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
576 |
570 |
$10K |
| 92015 |
Determination of refractive state |
2,064 |
2,009 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
60 |
59 |
$1K |