| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,929 |
1,729 |
$166K |
| V2020 |
Frames, purchases |
2,892 |
2,576 |
$115K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,274 |
1,160 |
$96K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,536 |
1,390 |
$51K |
| 92015 |
Determination of refractive state |
3,675 |
3,292 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
232 |
219 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
27 |
24 |
$961.28 |
| V2750 |
Anti-reflective coating, per lens |
39 |
39 |
$42.08 |