| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,296 |
1,242 |
$109K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
483 |
433 |
$32K |
| V2020 |
Frames, purchases |
1,395 |
1,253 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,478 |
873 |
$19K |
| 92015 |
Determination of refractive state |
1,936 |
1,775 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
36 |
25 |
$464.50 |