| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
974 |
957 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
735 |
722 |
$33K |
| 92015 |
Determination of refractive state |
1,286 |
1,254 |
$25K |
| V2020 |
Frames, purchases |
892 |
872 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
713 |
701 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
852 |
832 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
15 |
$464.00 |