| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,709 |
1,653 |
$113K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
551 |
533 |
$42K |
| 92015 |
Determination of refractive state |
2,909 |
2,804 |
$40K |
| V2020 |
Frames, purchases |
1,389 |
1,287 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
820 |
754 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
404 |
360 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
15 |
15 |
$956.10 |
| V2756 |
Eye glass case |
1,005 |
928 |
$934.50 |