| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,398 |
5,992 |
$591K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,460 |
3,171 |
$381K |
| V2020 |
Frames, purchases |
5,252 |
5,010 |
$197K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,198 |
2,117 |
$89K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,811 |
4,592 |
$80K |
| V2025 |
Deluxe frame |
1,043 |
1,023 |
$74K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
81 |
81 |
$4K |
| 92015 |
Determination of refractive state |
1,527 |
1,421 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
32 |
28 |
$1K |