| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,313 |
2,106 |
$139K |
| V2020 |
Frames, purchases |
2,662 |
2,550 |
$112K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
744 |
688 |
$64K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,406 |
1,074 |
$45K |
| 92015 |
Determination of refractive state |
3,436 |
3,129 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
387 |
318 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
370 |
336 |
$14K |
| 92250 |
|
216 |
171 |
$6K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
722 |
588 |
$6K |
| 92285 |
|
14 |
12 |
$295.58 |