| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,841 |
1,743 |
$128K |
| V2020 |
Frames, purchases |
1,560 |
1,402 |
$90K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
895 |
755 |
$69K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,447 |
1,297 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
668 |
577 |
$26K |
| 92015 |
Determination of refractive state |
1,601 |
1,442 |
$24K |
| 92250 |
|
215 |
196 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
160 |
136 |
$4K |