| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,861 |
2,649 |
$158K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,060 |
1,911 |
$97K |
| V2020 |
Frames, purchases |
2,645 |
2,473 |
$71K |
| 92015 |
Determination of refractive state |
5,190 |
4,820 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,157 |
1,075 |
$55K |
| V2755 |
U-v lens, per lens |
2,187 |
2,038 |
$42K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
1,690 |
1,595 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
92 |
90 |
$4K |