| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
212 |
202 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
177 |
144 |
$9K |
| V2020 |
Frames, purchases |
326 |
314 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
46 |
46 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
33 |
31 |
$1K |
| V2025 |
Deluxe frame |
12 |
12 |
$142.56 |