| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
667 |
608 |
$55K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
556 |
499 |
$49K |
| 92015 |
Determination of refractive state |
1,839 |
1,707 |
$48K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
289 |
252 |
$25K |
| 92002 |
|
476 |
464 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
209 |
208 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
120 |
77 |
$79.72 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
101 |
63 |
$68.98 |
| 3072F |
|
15 |
15 |
$0.00 |