| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
776 |
697 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
271 |
270 |
$5K |
| V2020 |
Frames, purchases |
299 |
298 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
160 |
121 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
203 |
202 |
$1K |
| 92015 |
Determination of refractive state |
99 |
88 |
$0.00 |