| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
565 |
468 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
199 |
157 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
356 |
308 |
$6K |
| 92015 |
Determination of refractive state |
587 |
477 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
55 |
43 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
230 |
188 |
$2K |