| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,320 |
1,299 |
$50K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,176 |
1,329 |
$42K |
| V2020 |
Frames, purchases |
1,576 |
1,564 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
242 |
230 |
$8K |
| 92250 |
|
178 |
168 |
$5K |
| 92015 |
Determination of refractive state |
1,660 |
1,637 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
883 |
472 |
$720.00 |
| V2755 |
U-v lens, per lens |
48 |
24 |
$0.00 |