| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
781 |
731 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
794 |
744 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
500 |
472 |
$6K |
| V2020 |
Frames, purchases |
912 |
851 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
405 |
384 |
$2K |
| V2500 |
Contact lens, pmma, spherical, per lens |
42 |
39 |
$664.80 |
| 92310 |
|
51 |
50 |
$586.00 |