| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,164 |
5,851 |
$370K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
966 |
931 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
88 |
88 |
$3K |
| V2020 |
Frames, purchases |
103 |
103 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
102 |
102 |
$2K |
| 92310 |
|
100 |
90 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
36 |
36 |
$280.00 |
| 92015 |
Determination of refractive state |
17 |
14 |
$65.00 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |