| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
819 |
808 |
$92K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
779 |
771 |
$77K |
| V2020 |
Frames, purchases |
229 |
216 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
103 |
98 |
$8K |
| 92015 |
Determination of refractive state |
764 |
759 |
$5K |
| 92060 |
|
456 |
449 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
24 |
$138.00 |