| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
601 |
590 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
557 |
543 |
$14K |
| V2020 |
Frames, purchases |
896 |
796 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
517 |
458 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
184 |
179 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
79 |
71 |
$550.00 |
| 92015 |
Determination of refractive state |
40 |
40 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
17 |
14 |
$0.00 |