| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,869 |
2,691 |
$200K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
720 |
689 |
$63K |
| V2020 |
Frames, purchases |
3,243 |
2,996 |
$53K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,335 |
2,164 |
$44K |
| 92015 |
Determination of refractive state |
3,835 |
3,436 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
12 |
$692.60 |
| 92133 |
|
16 |
16 |
$356.07 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
14 |
12 |
$265.68 |