| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
506 |
440 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
362 |
316 |
$14K |
| V2020 |
Frames, purchases |
816 |
565 |
$14K |
| 92015 |
Determination of refractive state |
746 |
656 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
251 |
228 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
595 |
406 |
$108.60 |
| V2750 |
Anti-reflective coating, per lens |
166 |
136 |
$0.00 |
| 2024F |
|
241 |
236 |
$0.00 |
| 3072F |
|
62 |
62 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
414 |
297 |
$0.00 |