| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,248 |
2,937 |
$140K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,472 |
1,240 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
361 |
332 |
$18K |
| V2020 |
Frames, purchases |
984 |
809 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
95 |
81 |
$1K |
| 92015 |
Determination of refractive state |
67 |
65 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
73 |
66 |
$1K |
| 92133 |
|
27 |
25 |
$256.95 |
| 2022F |
|
139 |
138 |
$0.00 |
| 2027F |
|
72 |
65 |
$0.00 |
| 5010F |
|
97 |
96 |
$0.00 |