| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,285 |
1,271 |
$81K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
807 |
799 |
$81K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
453 |
451 |
$55K |
| V2025 |
Deluxe frame |
598 |
592 |
$39K |
| 92015 |
Determination of refractive state |
1,409 |
1,392 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
525 |
503 |
$11K |
| V2020 |
Frames, purchases |
252 |
246 |
$9K |
| 92083 |
|
69 |
69 |
$3K |
| 92025 |
|
112 |
112 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$198.66 |