| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,026 |
1,018 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
132 |
125 |
$990.80 |
| 92015 |
Determination of refractive state |
827 |
810 |
$712.80 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
790 |
387 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
370 |
183 |
$0.00 |
| V2020 |
Frames, purchases |
643 |
630 |
$0.00 |