| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,057 |
967 |
$61K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
356 |
339 |
$30K |
| 92015 |
Determination of refractive state |
2,083 |
1,877 |
$25K |
| V2020 |
Frames, purchases |
685 |
651 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
323 |
304 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$480.22 |
| V2756 |
Eye glass case |
277 |
265 |
$259.15 |