| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,716 |
2,666 |
$211K |
| V2020 |
Frames, purchases |
1,956 |
1,928 |
$101K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
610 |
599 |
$52K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,126 |
1,115 |
$38K |
| 92015 |
Determination of refractive state |
2,263 |
2,236 |
$33K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,096 |
1,079 |
$33K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
225 |
189 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
455 |
453 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
37 |
37 |
$1K |
| 92250 |
|
43 |
43 |
$1K |