| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
606 |
602 |
$58K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
337 |
334 |
$39K |
| V2020 |
Frames, purchases |
494 |
491 |
$34K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
473 |
471 |
$20K |
| 92015 |
Determination of refractive state |
939 |
931 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
98 |
95 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
24 |
24 |
$909.18 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$601.75 |