| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,103 |
932 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
899 |
826 |
$18K |
| V2020 |
Frames, purchases |
1,124 |
1,043 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
407 |
333 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
650 |
605 |
$5K |
| 92015 |
Determination of refractive state |
901 |
820 |
$209.22 |
| V2750 |
Anti-reflective coating, per lens |
184 |
172 |
$0.00 |