| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,069 |
2,687 |
$147K |
| V2020 |
Frames, purchases |
3,262 |
2,784 |
$58K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,373 |
1,871 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,164 |
1,569 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
789 |
644 |
$20K |
| 92015 |
Determination of refractive state |
4,487 |
3,881 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,634 |
1,286 |
$15K |
| 92002 |
|
185 |
160 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
27 |
24 |
$587.80 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
28 |
25 |
$558.62 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
12 |
$508.56 |