| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,972 |
1,825 |
$178K |
| 92060 |
|
1,055 |
954 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
402 |
366 |
$44K |
| 92015 |
Determination of refractive state |
2,680 |
2,478 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
89 |
86 |
$2K |
| V2020 |
Frames, purchases |
108 |
105 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$917.69 |
| 92285 |
|
15 |
12 |
$211.32 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
19 |
19 |
$182.00 |