| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,446 |
1,444 |
$47K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,427 |
5,403 |
$44K |
| 92015 |
Determination of refractive state |
2,301 |
2,297 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
192 |
104 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
193 |
90 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
200 |
200 |
$0.00 |
| V2020 |
Frames, purchases |
349 |
330 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
27 |
27 |
$0.00 |