| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,891 |
1,770 |
$219K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
618 |
580 |
$72K |
| V2020 |
Frames, purchases |
2,355 |
2,205 |
$17K |
| 92015 |
Determination of refractive state |
1,712 |
1,651 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,636 |
965 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,169 |
684 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
328 |
308 |
$588.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
80 |
50 |
$126.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
19 |
12 |
$0.00 |