| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,386 |
1,338 |
$106K |
| V2020 |
Frames, purchases |
1,478 |
1,416 |
$42K |
| 92015 |
Determination of refractive state |
2,879 |
2,678 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
627 |
462 |
$17K |
| 92002 |
|
105 |
105 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
45 |
44 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
39 |
30 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19 |
12 |
$783.98 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
59 |
59 |
$326.00 |