| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
430 |
387 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
186 |
164 |
$18K |
| V2020 |
Frames, purchases |
381 |
331 |
$17K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
348 |
296 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
185 |
155 |
$12K |
| V2755 |
U-v lens, per lens |
327 |
277 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
340 |
290 |
$6K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
332 |
281 |
$6K |
| 92250 |
|
163 |
154 |
$5K |
| 92015 |
Determination of refractive state |
144 |
132 |
$477.19 |