| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,395 |
1,364 |
$121K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
429 |
417 |
$43K |
| 92015 |
Determination of refractive state |
2,091 |
2,025 |
$30K |
| V2025 |
Deluxe frame |
192 |
182 |
$8K |
| 92250 |
|
169 |
160 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
69 |
65 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
171 |
158 |
$3K |
| V2020 |
Frames, purchases |
92 |
82 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16 |
14 |
$174.05 |