| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
825 |
810 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
585 |
572 |
$61K |
| 92015 |
Determination of refractive state |
1,416 |
1,382 |
$19K |
| V2020 |
Frames, purchases |
268 |
251 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
182 |
169 |
$4K |
| 92250 |
|
39 |
38 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
18 |
$338.26 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
18 |
18 |
$234.00 |