| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,458 |
1,395 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
880 |
825 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,057 |
1,958 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
431 |
418 |
$32K |
| 92015 |
Determination of refractive state |
2,324 |
2,206 |
$17K |
| V2750 |
Anti-reflective coating, per lens |
426 |
400 |
$17K |
| V2020 |
Frames, purchases |
1,785 |
1,678 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,376 |
1,298 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
678 |
638 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
62 |
62 |
$706.42 |
| V2025 |
Deluxe frame |
1,172 |
1,115 |
$0.00 |