| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
997 |
985 |
$43K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,060 |
1,022 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,780 |
972 |
$33K |
| V2020 |
Frames, purchases |
1,725 |
1,705 |
$24K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
282 |
149 |
$7K |
| 92015 |
Determination of refractive state |
1,799 |
1,786 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,460 |
1,316 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
13 |
$374.01 |
| V2755 |
U-v lens, per lens |
150 |
75 |
$0.00 |