| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
672 |
658 |
$29K |
| V2020 |
Frames, purchases |
924 |
906 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
248 |
248 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
519 |
504 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
412 |
408 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$210.00 |