| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,442 |
1,438 |
$75K |
| V2020 |
Frames, purchases |
1,007 |
999 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
597 |
596 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
443 |
416 |
$22K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
162 |
161 |
$16K |
| V2025 |
Deluxe frame |
171 |
170 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
266 |
260 |
$6K |
| 92015 |
Determination of refractive state |
364 |
362 |
$32.75 |