| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
664 |
661 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
914 |
906 |
$20K |
| V2020 |
Frames, purchases |
995 |
987 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
286 |
284 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
576 |
570 |
$6K |
| 92015 |
Determination of refractive state |
1,453 |
1,441 |
$0.00 |