| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,489 |
1,396 |
$115K |
| V2020 |
Frames, purchases |
2,632 |
2,498 |
$99K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
738 |
704 |
$65K |
| 92015 |
Determination of refractive state |
3,541 |
3,370 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
626 |
443 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
570 |
344 |
$17K |
| 92250 |
|
530 |
503 |
$15K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
35 |
25 |
$1K |