| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
518 |
512 |
$18K |
| V2020 |
Frames, purchases |
873 |
848 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
363 |
359 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
329 |
324 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
455 |
446 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
146 |
142 |
$3K |