| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,585 |
3,360 |
$201K |
| V2020 |
Frames, purchases |
5,009 |
4,575 |
$184K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,523 |
2,271 |
$106K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,838 |
1,659 |
$98K |
| 92015 |
Determination of refractive state |
7,442 |
6,863 |
$94K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
151 |
126 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
27 |
25 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
93 |
93 |
$144.00 |