| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
491 |
412 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
439 |
419 |
$7K |
| V2020 |
Frames, purchases |
494 |
472 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
260 |
217 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
333 |
320 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
73 |
65 |
$0.00 |
| 92015 |
Determination of refractive state |
348 |
319 |
$0.00 |