| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
592 |
532 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
268 |
238 |
$21K |
| V2020 |
Frames, purchases |
673 |
590 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
345 |
303 |
$7K |
| 92250 |
|
36 |
26 |
$871.56 |
| V2756 |
Eye glass case |
554 |
487 |
$510.68 |
| 92015 |
Determination of refractive state |
1,122 |
1,010 |
$30.10 |