| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
526 |
508 |
$19K |
| V2020 |
Frames, purchases |
985 |
953 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
538 |
497 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
100 |
98 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
681 |
506 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
147 |
91 |
$3K |