| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
732 |
683 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
214 |
205 |
$24K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
86 |
79 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
111 |
104 |
$3K |
| V2020 |
Frames, purchases |
80 |
70 |
$3K |
| 92060 |
|
46 |
44 |
$2K |
| 92015 |
Determination of refractive state |
2,713 |
2,546 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
106 |
99 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
99 |
92 |
$1K |