| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,912 |
2,677 |
$244K |
| V2020 |
Frames, purchases |
3,968 |
3,596 |
$145K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
807 |
727 |
$79K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,762 |
1,575 |
$76K |
| 92015 |
Determination of refractive state |
5,482 |
5,015 |
$65K |
| V2755 |
U-v lens, per lens |
2,732 |
2,534 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
374 |
332 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$615.50 |
| V2760 |
Scratch resistant coating, per lens |
42 |
42 |
$55.60 |