| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
921 |
912 |
$104K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
721 |
695 |
$65K |
| 92060 |
|
682 |
674 |
$35K |
| 92250 |
|
747 |
727 |
$17K |
| V2020 |
Frames, purchases |
203 |
203 |
$15K |
| 92015 |
Determination of refractive state |
1,591 |
1,567 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$1K |
| 92082 |
|
17 |
17 |
$711.66 |
| 92285 |
|
14 |
14 |
$159.78 |