| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,246 |
3,076 |
$393K |
| V2020 |
Frames, purchases |
4,339 |
3,889 |
$213K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,202 |
1,160 |
$126K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,872 |
1,679 |
$97K |
| 92015 |
Determination of refractive state |
5,183 |
4,917 |
$84K |
| V2755 |
U-v lens, per lens |
899 |
812 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
373 |
345 |
$19K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
55 |
49 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
12 |
$746.62 |
| 92310 |
|
16 |
14 |
$120.00 |