| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,582 |
1,490 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,507 |
1,383 |
$20K |
| V2020 |
Frames, purchases |
3,953 |
3,662 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,647 |
2,450 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
582 |
478 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,318 |
1,200 |
$6K |
| 92015 |
Determination of refractive state |
2,494 |
2,281 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$0.00 |