| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,612 |
1,539 |
$105K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
652 |
620 |
$55K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,278 |
2,162 |
$38K |
| V2750 |
Anti-reflective coating, per lens |
718 |
464 |
$34K |
| 92015 |
Determination of refractive state |
2,630 |
2,502 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,113 |
1,286 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,376 |
1,472 |
$19K |
| V2020 |
Frames, purchases |
1,548 |
1,465 |
$14K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
13 |
13 |
$1K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
16 |
16 |
$0.00 |