| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,338 |
1,265 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
921 |
864 |
$72K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
543 |
471 |
$15K |
| V2020 |
Frames, purchases |
767 |
688 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
48 |
44 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
67 |
66 |
$1K |
| 92015 |
Determination of refractive state |
1,441 |
1,361 |
$427.50 |
| 3072F |
|
178 |
169 |
$270.00 |