| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,452 |
1,427 |
$40K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
508 |
498 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
154 |
140 |
$7K |
| 92015 |
Determination of refractive state |
1,051 |
1,023 |
$2K |
| V2020 |
Frames, purchases |
534 |
517 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
311 |
304 |
$924.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
69 |
67 |
$265.24 |
| 3072F |
|
17 |
17 |
$0.00 |