| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,470 |
1,332 |
$93K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,717 |
1,596 |
$83K |
| V2020 |
Frames, purchases |
2,122 |
1,995 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
347 |
332 |
$28K |
| 92002 |
|
455 |
438 |
$21K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
276 |
254 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
802 |
771 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
338 |
323 |
$5K |
| 92250 |
|
50 |
37 |
$688.65 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$297.83 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
15 |
15 |
$228.35 |
| 92015 |
Determination of refractive state |
1,024 |
1,007 |
$0.00 |