| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
509 |
500 |
$18K |
| V2020 |
Frames, purchases |
547 |
541 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
472 |
471 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
133 |
133 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
128 |
124 |
$4K |
| 92015 |
Determination of refractive state |
12 |
12 |
$228.00 |