| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,808 |
1,691 |
$136K |
| V2020 |
Frames, purchases |
1,367 |
1,258 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
348 |
286 |
$28K |
| 92015 |
Determination of refractive state |
2,685 |
2,461 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
310 |
261 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
177 |
176 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
92 |
90 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$1K |