| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,453 |
4,339 |
$83K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,599 |
1,505 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,616 |
1,583 |
$70K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,685 |
2,630 |
$59K |
| 92250 |
|
1,359 |
1,334 |
$59K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
564 |
562 |
$19K |
| 92015 |
Determination of refractive state |
563 |
560 |
$6K |
| 92081 |
|
197 |
192 |
$5K |
| 92083 |
|
97 |
97 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
430 |
407 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
70 |
63 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
150 |
146 |
$3K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
156 |
155 |
$2K |
| 76514 |
|
192 |
185 |
$873.34 |
| 92285 |
|
14 |
13 |
$747.76 |
| 92020 |
|
34 |
34 |
$547.00 |
| 92082 |
|
15 |
15 |
$512.88 |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
14 |
14 |
$449.00 |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
12 |
12 |
$250.00 |