| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,052 |
3,840 |
$318K |
| V2020 |
Frames, purchases |
4,232 |
3,984 |
$152K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,239 |
1,138 |
$103K |
| 92015 |
Determination of refractive state |
6,505 |
6,104 |
$76K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,751 |
1,648 |
$46K |
| V2755 |
U-v lens, per lens |
1,512 |
1,453 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
217 |
209 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
84 |
71 |
$3K |
| 92250 |
|
15 |
13 |
$216.09 |
| V2744 |
Tint, photochromatic, per lens |
13 |
13 |
$90.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
33 |
29 |
$48.00 |