| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,367 |
1,304 |
$117K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,286 |
1,178 |
$77K |
| V2020 |
Frames, purchases |
1,764 |
1,613 |
$46K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,405 |
839 |
$16K |
| 92060 |
|
242 |
186 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
111 |
97 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
82 |
61 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
44 |
40 |
$485.12 |
| 92015 |
Determination of refractive state |
947 |
797 |
$150.50 |