| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
957 |
933 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
746 |
726 |
$11K |
| 92015 |
Determination of refractive state |
1,476 |
1,414 |
$2K |
| V2020 |
Frames, purchases |
376 |
359 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
552 |
321 |
$1K |
| 92225 |
|
14 |
14 |
$276.92 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
133 |
73 |
$28.50 |
| 2025F |
|
16 |
16 |
$0.00 |
| 92250 |
|
62 |
52 |
$0.00 |
| 3072F |
|
42 |
42 |
$0.00 |