| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
326 |
300 |
$10K |
| V2020 |
Frames, purchases |
576 |
524 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
418 |
374 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
168 |
152 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
226 |
196 |
$2K |
| 92015 |
Determination of refractive state |
404 |
366 |
$0.00 |