| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,681 |
1,601 |
$136K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
515 |
505 |
$53K |
| V2020 |
Frames, purchases |
2,001 |
1,918 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
834 |
631 |
$31K |
| 92015 |
Determination of refractive state |
2,629 |
2,502 |
$31K |
| V2755 |
U-v lens, per lens |
1,041 |
976 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
652 |
632 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
135 |
125 |
$144.00 |