| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,253 |
1,097 |
$61K |
| V2020 |
Frames, purchases |
631 |
583 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
510 |
472 |
$20K |
| 92015 |
Determination of refractive state |
2,042 |
1,742 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
81 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
18 |
12 |
$550.11 |