| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,134 |
5,116 |
$259K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,778 |
2,769 |
$146K |
| V2020 |
Frames, purchases |
372 |
370 |
$11K |
| 92015 |
Determination of refractive state |
74 |
74 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
34 |
33 |
$1K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
13 |
13 |
$975.00 |