| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,714 |
4,210 |
$167K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,367 |
1,215 |
$116K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,060 |
951 |
$116K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,187 |
1,018 |
$57K |
| 92015 |
Determination of refractive state |
3,271 |
2,923 |
$47K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
749 |
639 |
$43K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
115 |
91 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
150 |
135 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
34 |
30 |
$2K |