| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
540 |
502 |
$47K |
| V2020 |
Frames, purchases |
913 |
893 |
$32K |
| 92015 |
Determination of refractive state |
1,929 |
1,826 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
129 |
129 |
$15K |
| V2755 |
U-v lens, per lens |
529 |
515 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
120 |
83 |
$4K |