| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
466 |
401 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
880 |
715 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
749 |
617 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
69 |
58 |
$0.00 |
| V2020 |
Frames, purchases |
1,260 |
1,022 |
$0.00 |
| 92015 |
Determination of refractive state |
864 |
771 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,196 |
999 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
17 |
15 |
$0.00 |