| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,449 |
1,347 |
$132K |
| V2020 |
Frames, purchases |
1,784 |
1,682 |
$121K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
696 |
655 |
$80K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,594 |
1,508 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,631 |
1,546 |
$15K |
| 92250 |
|
14 |
12 |
$409.60 |
| 92015 |
Determination of refractive state |
2,408 |
2,247 |
$104.16 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
64 |
59 |
$0.00 |