| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
824 |
699 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
334 |
304 |
$19K |
| V2020 |
Frames, purchases |
391 |
345 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
220 |
165 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
272 |
246 |
$563.73 |
| 92015 |
Determination of refractive state |
863 |
776 |
$298.92 |
| 92342 |
|
304 |
267 |
$262.18 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
269 |
231 |
$107.18 |
| 92341 |
|
42 |
41 |
$15.00 |
| V2750 |
Anti-reflective coating, per lens |
169 |
144 |
$0.00 |