| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
545 |
528 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
141 |
139 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
318 |
273 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
252 |
247 |
$6K |
| 92015 |
Determination of refractive state |
210 |
208 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
38 |
38 |
$3K |