| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,047 |
981 |
$88K |
| V2020 |
Frames, purchases |
3,238 |
2,776 |
$73K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,197 |
2,624 |
$68K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,407 |
1,170 |
$58K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,472 |
2,043 |
$39K |
| 92015 |
Determination of refractive state |
2,576 |
2,235 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
597 |
460 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
231 |
194 |
$6K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$225.08 |