| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,581 |
1,519 |
$65K |
| V2020 |
Frames, purchases |
1,254 |
854 |
$50K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,721 |
610 |
$47K |
| S0500 |
Disposable contact lens, per lens |
361 |
247 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
105 |
104 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
796 |
242 |
$921.00 |