| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,501 |
1,429 |
$102K |
| V2020 |
Frames, purchases |
1,648 |
1,577 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
438 |
422 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
817 |
772 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
324 |
321 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
369 |
362 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
46 |
43 |
$2K |
| 92015 |
Determination of refractive state |
1,667 |
1,587 |
$2K |
| V2756 |
Eye glass case |
746 |
721 |
$760.32 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
15 |
$369.40 |