| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,314 |
1,156 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,359 |
1,236 |
$23K |
| V2020 |
Frames, purchases |
1,566 |
1,416 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
618 |
541 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,250 |
1,119 |
$11K |
| 92015 |
Determination of refractive state |
1,135 |
1,004 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
377 |
326 |
$0.00 |