| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,487 |
2,465 |
$130K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,981 |
1,953 |
$93K |
| V2020 |
Frames, purchases |
5,215 |
5,132 |
$73K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,235 |
2,205 |
$47K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,471 |
3,390 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,831 |
1,784 |
$24K |
| 92310 |
|
298 |
298 |
$17K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
288 |
287 |
$10K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
306 |
306 |
$6K |
| 92015 |
Determination of refractive state |
3,623 |
3,596 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
122 |
118 |
$830.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
63 |
63 |
$660.00 |
| V2744 |
Tint, photochromatic, per lens |
52 |
52 |
$0.00 |