| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,004 |
1,985 |
$131K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,056 |
1,037 |
$93K |
| V2020 |
Frames, purchases |
1,766 |
1,717 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
479 |
452 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
344 |
333 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
202 |
196 |
$1K |
| V2756 |
Eye glass case |
677 |
665 |
$679.24 |
| 92015 |
Determination of refractive state |
204 |
200 |
$30.10 |