| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,942 |
2,839 |
$259K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,304 |
2,161 |
$131K |
| V2020 |
Frames, purchases |
3,593 |
3,394 |
$85K |
| 92015 |
Determination of refractive state |
5,240 |
4,968 |
$71K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,047 |
984 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
747 |
725 |
$18K |
| V2756 |
Eye glass case |
3,376 |
3,191 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
24 |
$701.86 |
| 92250 |
|
105 |
82 |
$647.06 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
15 |
$280.72 |
| 3072F |
|
47 |
30 |
$250.00 |
| 99072 |
|
28 |
26 |
$0.00 |