| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,896 |
3,492 |
$111K |
| 92015 |
Determination of refractive state |
5,933 |
5,313 |
$72K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
799 |
710 |
$58K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
999 |
823 |
$42K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,198 |
764 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
315 |
277 |
$30K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
557 |
503 |
$29K |
| 92250 |
|
859 |
723 |
$20K |
| 92002 |
|
128 |
119 |
$7K |
| 92285 |
|
66 |
54 |
$439.43 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
31 |
29 |
$157.26 |