| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,117 |
1,956 |
$240K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,105 |
1,036 |
$101K |
| 92015 |
Determination of refractive state |
3,470 |
3,248 |
$53K |
| 92250 |
|
786 |
724 |
$36K |
| V2020 |
Frames, purchases |
795 |
724 |
$30K |
| V2755 |
U-v lens, per lens |
638 |
599 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
213 |
197 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
38 |
37 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
14 |
$1K |