| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,084 |
1,035 |
$94K |
| V2020 |
Frames, purchases |
1,643 |
1,549 |
$66K |
| 92015 |
Determination of refractive state |
2,008 |
1,903 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
229 |
212 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
532 |
337 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
80 |
76 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
63 |
55 |
$1K |