| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
692 |
692 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
506 |
506 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
327 |
267 |
$18K |
| V2020 |
Frames, purchases |
503 |
502 |
$13K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
115 |
115 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
134 |
134 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
55 |
43 |
$3K |