| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
785 |
772 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
313 |
307 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
474 |
462 |
$11K |
| V2020 |
Frames, purchases |
632 |
613 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
44 |
44 |
$559.00 |
| 92015 |
Determination of refractive state |
1,339 |
1,318 |
$0.00 |