| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,060 |
993 |
$92K |
| V2020 |
Frames, purchases |
1,862 |
1,701 |
$82K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
666 |
629 |
$71K |
| 92015 |
Determination of refractive state |
2,155 |
2,059 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
248 |
229 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
240 |
222 |
$9K |
| V2755 |
U-v lens, per lens |
37 |
37 |
$732.77 |