| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,499 |
1,458 |
$72K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,644 |
1,620 |
$48K |
| V2025 |
Deluxe frame |
822 |
817 |
$38K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
178 |
178 |
$8K |
| V2020 |
Frames, purchases |
387 |
379 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
569 |
562 |
$3K |
| 92015 |
Determination of refractive state |
1,214 |
1,205 |
$10.00 |