| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,319 |
1,289 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
766 |
746 |
$35K |
| V2020 |
Frames, purchases |
299 |
285 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
301 |
294 |
$8K |
| 92015 |
Determination of refractive state |
2,363 |
2,287 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
248 |
243 |
$1K |
| V2025 |
Deluxe frame |
12 |
12 |
$555.78 |