| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,418 |
2,202 |
$199K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,025 |
927 |
$96K |
| V2020 |
Frames, purchases |
2,408 |
2,246 |
$88K |
| 92015 |
Determination of refractive state |
4,751 |
4,263 |
$57K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
493 |
433 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
192 |
118 |
$6K |