| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,001 |
849 |
$83K |
| V2020 |
Frames, purchases |
1,530 |
1,206 |
$63K |
| 92015 |
Determination of refractive state |
2,329 |
1,946 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
144 |
121 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
150 |
98 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
206 |
157 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
59 |
56 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
56 |
41 |
$725.87 |