| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,756 |
1,715 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,877 |
1,876 |
$333.60 |
| V2020 |
Frames, purchases |
2,901 |
2,895 |
$20.00 |
| 92015 |
Determination of refractive state |
2,531 |
2,512 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
16 |
16 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
216 |
215 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,309 |
2,302 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
821 |
817 |
$0.00 |