| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,186 |
2,133 |
$91K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,556 |
2,187 |
$63K |
| V2020 |
Frames, purchases |
2,919 |
2,530 |
$56K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
855 |
851 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,882 |
1,529 |
$23K |
| 92310 |
|
58 |
58 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$452.40 |