| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
679 |
670 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
284 |
281 |
$27K |
| V2020 |
Frames, purchases |
862 |
823 |
$21K |
| 92015 |
Determination of refractive state |
1,412 |
1,404 |
$21K |
| 92370 |
|
609 |
587 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
123 |
121 |
$3K |
| V2756 |
Eye glass case |
890 |
849 |
$879.66 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
27 |
$714.56 |