| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
641 |
640 |
$37K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
955 |
923 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
327 |
327 |
$18K |
| V2020 |
Frames, purchases |
1,187 |
1,149 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
709 |
675 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
103 |
99 |
$4K |
| 92015 |
Determination of refractive state |
1,005 |
1,003 |
$791.54 |