| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
407 |
404 |
$40K |
| 92015 |
Determination of refractive state |
1,610 |
1,549 |
$33K |
| V2020 |
Frames, purchases |
778 |
758 |
$26K |
| 92002 |
|
383 |
369 |
$19K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
148 |
144 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
219 |
218 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
33 |
33 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$481.52 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
475 |
460 |
$0.00 |