| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,397 |
1,348 |
$22K |
| V2020 |
Frames, purchases |
551 |
548 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
525 |
340 |
$2K |
| 92015 |
Determination of refractive state |
960 |
949 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
96 |
91 |
$1K |
| 92250 |
|
14 |
14 |
$280.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
90 |
55 |
$252.70 |