| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
586 |
543 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
655 |
614 |
$11K |
| V2020 |
Frames, purchases |
800 |
742 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
175 |
166 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
350 |
322 |
$2K |
| 92015 |
Determination of refractive state |
890 |
837 |
$0.00 |