| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
501 |
501 |
$49K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
332 |
332 |
$39K |
| 92015 |
Determination of refractive state |
1,728 |
1,728 |
$27K |
| V2020 |
Frames, purchases |
324 |
324 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
153 |
153 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
13 |
$1K |