| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
502 |
498 |
$45K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
280 |
279 |
$21K |
| 92015 |
Determination of refractive state |
929 |
928 |
$19K |
| V2020 |
Frames, purchases |
464 |
460 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
386 |
385 |
$9K |
| V2799 |
Vision item or service, miscellaneous |
218 |
216 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$1K |