| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
705 |
700 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
484 |
478 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
755 |
746 |
$13K |
| V2020 |
Frames, purchases |
907 |
894 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
284 |
284 |
$3K |
| 92015 |
Determination of refractive state |
1,017 |
1,009 |
$0.00 |