| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
324 |
313 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,163 |
1,118 |
$24K |
| V2020 |
Frames, purchases |
1,229 |
1,188 |
$21K |
| 92015 |
Determination of refractive state |
698 |
675 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
78 |
78 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
124 |
120 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
117 |
117 |
$6K |