| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
484 |
476 |
$28K |
| V2020 |
Frames, purchases |
595 |
551 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
578 |
530 |
$5K |
| 92015 |
Determination of refractive state |
829 |
797 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
546 |
515 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
34 |
31 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
434 |
393 |
$420.00 |
| V2750 |
Anti-reflective coating, per lens |
29 |
27 |
$0.00 |