| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,016 |
917 |
$90K |
| V2020 |
Frames, purchases |
1,489 |
1,352 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
795 |
706 |
$39K |
| 92015 |
Determination of refractive state |
1,677 |
1,527 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
235 |
222 |
$24K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$819.17 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
18 |
$692.54 |
| V2755 |
U-v lens, per lens |
14 |
14 |
$330.34 |