| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
67 |
49 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
157 |
106 |
$2K |
| V2020 |
Frames, purchases |
147 |
103 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
56 |
34 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
107 |
74 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
79 |
55 |
$904.82 |
| 92015 |
Determination of refractive state |
142 |
96 |
$501.28 |