| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,250 |
2,102 |
$109K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,645 |
1,567 |
$89K |
| V2020 |
Frames, purchases |
1,181 |
1,126 |
$25K |
| 92015 |
Determination of refractive state |
4,330 |
4,092 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
124 |
65 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
14 |
$698.74 |