| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,160 |
5,028 |
$450K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,219 |
3,128 |
$339K |
| V2020 |
Frames, purchases |
6,935 |
6,608 |
$211K |
| 92015 |
Determination of refractive state |
10,400 |
9,736 |
$127K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,872 |
2,830 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
901 |
850 |
$40K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
972 |
957 |
$14K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
64 |
64 |
$2K |
| V2755 |
U-v lens, per lens |
26 |
26 |
$520.00 |