| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
637 |
621 |
$75K |
| 92250 |
|
647 |
621 |
$24K |
| V2020 |
Frames, purchases |
343 |
216 |
$21K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
137 |
78 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
337 |
212 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
265 |
168 |
$7K |
| V2750 |
Anti-reflective coating, per lens |
342 |
215 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
45 |
45 |
$5K |
| V2755 |
U-v lens, per lens |
283 |
174 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
13 |
$730.93 |
| 92015 |
Determination of refractive state |
731 |
705 |
$41.51 |