| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
691 |
689 |
$47K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
467 |
465 |
$43K |
| V2020 |
Frames, purchases |
1,248 |
1,216 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
378 |
369 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
317 |
310 |
$7K |
| V2756 |
Eye glass case |
1,116 |
1,101 |
$1K |