| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,096 |
1,070 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
568 |
556 |
$4K |
| 92015 |
Determination of refractive state |
732 |
727 |
$937.20 |
| V2020 |
Frames, purchases |
674 |
670 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
498 |
326 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
47 |
27 |
$0.00 |