| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
637 |
580 |
$55K |
| V2020 |
Frames, purchases |
1,654 |
1,474 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
606 |
562 |
$28K |
| V2755 |
U-v lens, per lens |
1,117 |
1,000 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
165 |
161 |
$19K |
| 92015 |
Determination of refractive state |
1,378 |
1,257 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
308 |
263 |
$9K |
| 92250 |
|
186 |
165 |
$5K |
| 92081 |
|
107 |
90 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
15 |
$606.18 |