| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,002 |
1,807 |
$154K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
843 |
795 |
$77K |
| V2020 |
Frames, purchases |
1,986 |
1,838 |
$68K |
| 92015 |
Determination of refractive state |
3,975 |
3,628 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
708 |
666 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
48 |
38 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
29 |
$883.44 |