| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
456 |
450 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
750 |
734 |
$19K |
| V2020 |
Frames, purchases |
960 |
940 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
393 |
383 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
510 |
494 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$452.40 |
| 92015 |
Determination of refractive state |
998 |
979 |
$0.00 |