| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,701 |
2,510 |
$236K |
| V2020 |
Frames, purchases |
2,377 |
2,235 |
$83K |
| 92015 |
Determination of refractive state |
2,903 |
2,736 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
653 |
624 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
175 |
175 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
351 |
345 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
42 |
40 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$464.20 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
43 |
38 |
$352.00 |
| V2744 |
Tint, photochromatic, per lens |
14 |
13 |
$90.00 |