| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,196 |
1,186 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,010 |
998 |
$38K |
| V2020 |
Frames, purchases |
2,020 |
1,978 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
981 |
959 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
991 |
956 |
$10K |
| 92015 |
Determination of refractive state |
2,328 |
2,306 |
$1K |
| 92310 |
|
27 |
27 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$323.44 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$0.00 |