| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
1,202 |
1,175 |
$61K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
286 |
283 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
337 |
329 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,136 |
1,110 |
$31K |
| 92015 |
Determination of refractive state |
607 |
599 |
$10K |
| 92250 |
|
116 |
115 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
992 |
964 |
$0.00 |