| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,541 |
1,502 |
$92K |
| V2020 |
Frames, purchases |
1,165 |
1,099 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
146 |
141 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
115 |
108 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
104 |
91 |
$2K |
| V2756 |
Eye glass case |
406 |
395 |
$412.56 |
| 92015 |
Determination of refractive state |
318 |
306 |
$0.00 |