| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
676 |
671 |
$29K |
| V2020 |
Frames, purchases |
1,102 |
1,094 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
662 |
660 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
362 |
353 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
357 |
355 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
14 |
$527.80 |