| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
519 |
515 |
$22K |
| V2020 |
Frames, purchases |
798 |
775 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
481 |
472 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
224 |
222 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
279 |
262 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
28 |
28 |
$1K |
| 92015 |
Determination of refractive state |
1,011 |
1,004 |
$140.49 |