| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,522 |
1,338 |
$67K |
| V2020 |
Frames, purchases |
2,280 |
1,852 |
$38K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,367 |
1,824 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
671 |
527 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,232 |
974 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,084 |
807 |
$11K |
| 92015 |
Determination of refractive state |
2,197 |
1,840 |
$10K |
| 99173 |
|
903 |
571 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
14 |
$216.80 |