| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,390 |
1,355 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
294 |
282 |
$13K |
| V2599 |
Contact lens, other type |
20 |
17 |
$1K |
| 92015 |
Determination of refractive state |
299 |
295 |
$1K |
| V2020 |
Frames, purchases |
19 |
17 |
$664.83 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
16 |
12 |
$640.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$273.00 |