| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
477 |
338 |
$14K |
| V2020 |
Frames, purchases |
557 |
438 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
411 |
328 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
199 |
144 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
83 |
57 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
224 |
178 |
$1K |