| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,046 |
914 |
$94K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
649 |
567 |
$67K |
| V2781 |
Progressive lens, per lens |
984 |
826 |
$60K |
| V2020 |
Frames, purchases |
1,174 |
968 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
897 |
742 |
$35K |
| V2750 |
Anti-reflective coating, per lens |
1,320 |
1,085 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,367 |
1,116 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,320 |
1,084 |
$21K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
223 |
170 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
76 |
65 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
39 |
$2K |
| 92015 |
Determination of refractive state |
1,662 |
1,501 |
$678.96 |
| V2744 |
Tint, photochromatic, per lens |
19 |
15 |
$207.86 |