| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
661 |
656 |
$63K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
703 |
701 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
209 |
208 |
$10K |
| 92015 |
Determination of refractive state |
1,067 |
1,058 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
105 |
105 |
$148.13 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
32 |
16 |
$0.00 |