| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
766 |
568 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
481 |
348 |
$13K |
| V2020 |
Frames, purchases |
1,018 |
788 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
49 |
26 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
82 |
37 |
$1K |
| V2799 |
Vision item or service, miscellaneous |
38 |
38 |
$563.16 |
| 92015 |
Determination of refractive state |
290 |
284 |
$0.00 |