| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,191 |
1,117 |
$72K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,914 |
1,775 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
316 |
294 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,633 |
1,203 |
$17K |
| 92015 |
Determination of refractive state |
2,128 |
1,975 |
$17K |
| V2020 |
Frames, purchases |
1,343 |
1,230 |
$15K |
| V2750 |
Anti-reflective coating, per lens |
318 |
152 |
$15K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
244 |
53 |
$605.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
32 |
14 |
$259.74 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
12 |
$169.83 |