| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,207 |
1,171 |
$50K |
| V2020 |
Frames, purchases |
1,632 |
1,579 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,155 |
1,121 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
858 |
828 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
115 |
113 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
26 |
24 |
$895.00 |
| 92015 |
Determination of refractive state |
1,533 |
1,484 |
$161.76 |