| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
820 |
815 |
$65K |
| V2020 |
Frames, purchases |
1,370 |
1,354 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
549 |
547 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
710 |
403 |
$15K |
| 92015 |
Determination of refractive state |
722 |
717 |
$10K |
| 99243 |
|
52 |
50 |
$4K |
| 92250 |
|
15 |
15 |
$656.14 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
362 |
188 |
$228.43 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
14 |
$183.24 |