| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
839 |
817 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
405 |
393 |
$44K |
| V2020 |
Frames, purchases |
1,124 |
1,090 |
$36K |
| 92015 |
Determination of refractive state |
1,616 |
1,569 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
456 |
441 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
183 |
177 |
$7K |