| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,241 |
1,157 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,356 |
1,255 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,033 |
958 |
$19K |
| V2020 |
Frames, purchases |
1,553 |
1,432 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
770 |
715 |
$5K |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
15 |
13 |
$96.00 |