| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
467 |
419 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
478 |
476 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
334 |
317 |
$6K |
| V2020 |
Frames, purchases |
532 |
531 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
400 |
398 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
155 |
154 |
$0.00 |
| 92015 |
Determination of refractive state |
215 |
202 |
$0.00 |