| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,528 |
1,396 |
$123K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,010 |
935 |
$105K |
| V2020 |
Frames, purchases |
2,683 |
2,481 |
$83K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,318 |
1,227 |
$49K |
| 92015 |
Determination of refractive state |
2,847 |
2,643 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
422 |
384 |
$13K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
65 |
61 |
$2K |