| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,203 |
3,162 |
$118K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,822 |
2,771 |
$102K |
| 92015 |
Determination of refractive state |
2,928 |
2,867 |
$35K |
| V2500 |
Contact lens, pmma, spherical, per lens |
178 |
173 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
170 |
170 |
$4K |
| V2020 |
Frames, purchases |
229 |
227 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
207 |
207 |
$3K |