| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,343 |
3,042 |
$260K |
| V2020 |
Frames, purchases |
3,488 |
3,127 |
$126K |
| 92015 |
Determination of refractive state |
5,769 |
5,135 |
$80K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,680 |
1,611 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
806 |
718 |
$65K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
452 |
300 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$415.03 |