| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,629 |
1,332 |
$66K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,785 |
2,168 |
$51K |
| V2020 |
Frames, purchases |
2,657 |
2,207 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
913 |
778 |
$39K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,155 |
1,704 |
$26K |
| 92015 |
Determination of refractive state |
2,614 |
2,146 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
898 |
738 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
60 |
54 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
68 |
60 |
$1K |
| 92002 |
|
24 |
12 |
$376.29 |