| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
834 |
834 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
753 |
751 |
$19K |
| V2020 |
Frames, purchases |
519 |
517 |
$10K |
| V2025 |
Deluxe frame |
247 |
247 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
133 |
133 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
614 |
612 |
$4K |
| 92015 |
Determination of refractive state |
1,231 |
1,231 |
$0.00 |