| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,034 |
1,032 |
$88.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
395 |
393 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,052 |
1,047 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
476 |
475 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
13 |
$0.00 |
| 92015 |
Determination of refractive state |
1,487 |
1,482 |
$0.00 |
| V2020 |
Frames, purchases |
1,151 |
1,147 |
$0.00 |