| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
733 |
669 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
314 |
285 |
$33K |
| V2025 |
Deluxe frame |
905 |
893 |
$26K |
| 92015 |
Determination of refractive state |
1,583 |
1,456 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,084 |
1,059 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,019 |
1,005 |
$14K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
262 |
252 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
82 |
80 |
$3K |