| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
185 |
176 |
$16K |
| V2020 |
Frames, purchases |
91 |
83 |
$6K |
| 92015 |
Determination of refractive state |
282 |
273 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
111 |
103 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
13 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
24 |
$1K |