| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
537 |
524 |
$57K |
| 92015 |
Determination of refractive state |
1,553 |
1,493 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
152 |
148 |
$13K |
| V2020 |
Frames, purchases |
355 |
332 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
70 |
65 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
29 |
26 |
$60.00 |