| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,049 |
1,019 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
355 |
350 |
$31K |
| V2020 |
Frames, purchases |
1,025 |
984 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
689 |
405 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
159 |
111 |
$2K |
| V2756 |
Eye glass case |
878 |
854 |
$918.00 |