| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
783 |
758 |
$58K |
| V2020 |
Frames, purchases |
1,103 |
1,067 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
431 |
426 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
596 |
586 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
342 |
336 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
197 |
188 |
$8K |
| 92015 |
Determination of refractive state |
1,018 |
987 |
$5K |
| 92250 |
|
57 |
55 |
$1K |