| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
667 |
610 |
$61K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,110 |
1,047 |
$58K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,369 |
1,288 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
526 |
512 |
$48K |
| V2020 |
Frames, purchases |
1,270 |
1,192 |
$44K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
183 |
169 |
$13K |