| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
502 |
484 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
864 |
854 |
$4K |
| 92015 |
Determination of refractive state |
1,600 |
1,570 |
$2K |
| V2020 |
Frames, purchases |
784 |
774 |
$40.00 |
| V2760 |
Scratch resistant coating, per lens |
24 |
12 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,078 |
555 |
$0.00 |
| 3072F |
|
29 |
26 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
493 |
256 |
$0.00 |