| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,361 |
1,311 |
$113K |
| V2020 |
Frames, purchases |
2,363 |
2,282 |
$98K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
694 |
668 |
$37K |
| 92015 |
Determination of refractive state |
2,525 |
2,434 |
$34K |
| V2755 |
U-v lens, per lens |
1,116 |
1,079 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
215 |
202 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
210 |
206 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
214 |
211 |
$352.00 |