| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,778 |
1,728 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,199 |
1,166 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,406 |
1,265 |
$25K |
| V2020 |
Frames, purchases |
1,642 |
1,477 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
709 |
639 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
197 |
175 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
22 |
15 |
$440.00 |
| 92015 |
Determination of refractive state |
3,015 |
2,932 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |