| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,418 |
1,295 |
$57K |
| V2020 |
Frames, purchases |
228 |
228 |
$13K |
| 92250 |
|
303 |
279 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
65 |
47 |
$2K |
| 92015 |
Determination of refractive state |
270 |
237 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
39 |
39 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$2K |