| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
120 |
117 |
$6K |
| V2020 |
Frames, purchases |
311 |
302 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
212 |
205 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
96 |
90 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
295 |
286 |
$2K |
| 92015 |
Determination of refractive state |
346 |
337 |
$0.00 |