| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,517 |
1,419 |
$37K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,470 |
1,378 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,645 |
1,551 |
$31K |
| V2020 |
Frames, purchases |
1,832 |
1,717 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
902 |
858 |
$8K |
| 92310 |
|
227 |
217 |
$5K |
| V2500 |
Contact lens, pmma, spherical, per lens |
26 |
26 |
$604.00 |
| 92015 |
Determination of refractive state |
22 |
18 |
$114.12 |