| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
642 |
623 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
239 |
234 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
576 |
561 |
$18K |
| V2020 |
Frames, purchases |
810 |
787 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
554 |
541 |
$13K |
| 92015 |
Determination of refractive state |
1,249 |
1,205 |
$10K |
| 92370 |
|
390 |
374 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
55 |
$970.00 |