| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
909 |
828 |
$61K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
421 |
379 |
$34K |
| V2020 |
Frames, purchases |
1,338 |
1,220 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,014 |
910 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$324.50 |
| 92015 |
Determination of refractive state |
1,613 |
1,439 |
$1.64 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |