| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
712 |
696 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,227 |
1,200 |
$14K |
| V2020 |
Frames, purchases |
748 |
741 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
972 |
517 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
356 |
352 |
$1K |
| 92015 |
Determination of refractive state |
1,115 |
1,081 |
$990.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
130 |
68 |
$57.00 |