| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,870 |
1,863 |
$82K |
| V2020 |
Frames, purchases |
669 |
658 |
$29K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
663 |
584 |
$21K |
| 92015 |
Determination of refractive state |
771 |
767 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
65 |
65 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
73 |
70 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
13 |
$170.00 |