| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
843 |
835 |
$75K |
| V2020 |
Frames, purchases |
1,403 |
1,374 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,164 |
1,137 |
$26K |
| 92285 |
|
549 |
547 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
157 |
155 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
77 |
77 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
136 |
135 |
$1K |
| 92015 |
Determination of refractive state |
26 |
25 |
$345.34 |
| V2750 |
Anti-reflective coating, per lens |
15 |
15 |
$105.70 |