| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
911 |
858 |
$51K |
| V2020 |
Frames, purchases |
833 |
445 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
122 |
48 |
$854.32 |
| 92015 |
Determination of refractive state |
837 |
787 |
$267.62 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
364 |
152 |
$149.62 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
146 |
81 |
$27.18 |