| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,167 |
1,923 |
$169K |
| V2020 |
Frames, purchases |
1,911 |
1,717 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,041 |
1,000 |
$33K |
| 92015 |
Determination of refractive state |
2,317 |
2,067 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
418 |
234 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
110 |
76 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
91 |
52 |
$1K |