| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
488 |
427 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
433 |
426 |
$7K |
| V2020 |
Frames, purchases |
536 |
525 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
294 |
271 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
353 |
348 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
65 |
62 |
$0.00 |
| 92015 |
Determination of refractive state |
42 |
41 |
$0.00 |