| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
485 |
471 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
473 |
447 |
$29K |
| 92015 |
Determination of refractive state |
1,004 |
989 |
$15K |
| V2020 |
Frames, purchases |
503 |
457 |
$12K |
| 92370 |
|
469 |
426 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
50 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
27 |
$720.50 |
| V2756 |
Eye glass case |
471 |
428 |
$424.38 |