| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
456 |
446 |
$15K |
| V2020 |
Frames, purchases |
633 |
622 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
320 |
313 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
94 |
93 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
117 |
117 |
$1K |
| 92015 |
Determination of refractive state |
902 |
887 |
$0.00 |