| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,195 |
1,176 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,545 |
1,518 |
$30K |
| V2020 |
Frames, purchases |
1,695 |
1,668 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
659 |
652 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,076 |
1,056 |
$11K |
| 92310 |
|
72 |
72 |
$4K |
| 92250 |
|
105 |
104 |
$4K |
| 92015 |
Determination of refractive state |
1,865 |
1,833 |
$353.35 |