| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,428 |
1,383 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,168 |
1,146 |
$43K |
| V2020 |
Frames, purchases |
2,219 |
2,178 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,568 |
1,537 |
$34K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
958 |
933 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
284 |
281 |
$10K |
| 92015 |
Determination of refractive state |
2,733 |
2,682 |
$5K |