| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,950 |
2,676 |
$243K |
| V2020 |
Frames, purchases |
4,664 |
4,211 |
$150K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,234 |
2,031 |
$112K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
698 |
674 |
$72K |
| V2755 |
U-v lens, per lens |
3,175 |
2,821 |
$63K |
| 92015 |
Determination of refractive state |
3,481 |
3,175 |
$49K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
187 |
174 |
$14K |