| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
697 |
690 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
809 |
795 |
$22K |
| V2025 |
Deluxe frame |
441 |
429 |
$16K |
| V2020 |
Frames, purchases |
336 |
334 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
84 |
84 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
545 |
542 |
$2K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
15 |
14 |
$560.88 |
| 92015 |
Determination of refractive state |
944 |
934 |
$311.41 |