| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
292 |
286 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
163 |
160 |
$20K |
| V2020 |
Frames, purchases |
284 |
270 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
299 |
285 |
$14K |
| 92015 |
Determination of refractive state |
829 |
813 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
67 |
66 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
68 |
68 |
$4K |