| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
624 |
600 |
$42K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
999 |
914 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
344 |
336 |
$23K |
| V2020 |
Frames, purchases |
1,090 |
1,003 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
640 |
592 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
198 |
190 |
$3K |
| 92002 |
|
14 |
14 |
$686.00 |