| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,296 |
1,132 |
$56K |
| V2020 |
Frames, purchases |
2,016 |
1,671 |
$34K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,104 |
1,650 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
700 |
615 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,421 |
1,114 |
$15K |
| 92015 |
Determination of refractive state |
2,074 |
1,749 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
265 |
212 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
453 |
364 |
$5K |
| 99173 |
|
748 |
484 |
$2K |