| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,431 |
1,313 |
$97K |
| 92015 |
Determination of refractive state |
2,294 |
2,078 |
$28K |
| V2020 |
Frames, purchases |
878 |
812 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
91 |
79 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
141 |
138 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
58 |
52 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
13 |
13 |
$36.00 |