| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
583 |
582 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
483 |
479 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
701 |
690 |
$17K |
| V2020 |
Frames, purchases |
757 |
746 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
501 |
492 |
$6K |
| 92310 |
|
53 |
53 |
$4K |
| 92015 |
Determination of refractive state |
242 |
235 |
$0.00 |