| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
664 |
582 |
$62K |
| V2020 |
Frames, purchases |
1,521 |
1,326 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
461 |
399 |
$35K |
| 92015 |
Determination of refractive state |
2,104 |
1,853 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
612 |
511 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
338 |
305 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
71 |
63 |
$4K |