| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,506 |
2,256 |
$199K |
| V2020 |
Frames, purchases |
3,771 |
3,385 |
$122K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,024 |
921 |
$101K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,542 |
1,417 |
$66K |
| 92015 |
Determination of refractive state |
3,952 |
3,523 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
910 |
844 |
$31K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
104 |
78 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
21 |
15 |
$633.54 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
18 |
14 |
$103.00 |