| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
925 |
881 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
424 |
405 |
$49K |
| V2020 |
Frames, purchases |
762 |
675 |
$28K |
| V2781 |
Progressive lens, per lens |
368 |
346 |
$22K |
| V2750 |
Anti-reflective coating, per lens |
751 |
661 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
759 |
669 |
$16K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
220 |
181 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
743 |
665 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
264 |
241 |
$11K |
| V2744 |
Tint, photochromatic, per lens |
229 |
189 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$462.27 |
| 92015 |
Determination of refractive state |
1,459 |
1,378 |
$333.83 |