| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,003 |
911 |
$77K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
200 |
184 |
$16K |
| V2020 |
Frames, purchases |
1,423 |
1,279 |
$9K |
| 92015 |
Determination of refractive state |
1,729 |
1,599 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
950 |
848 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
341 |
294 |
$449.09 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,066 |
950 |
$275.12 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
42 |
$230.96 |
| 92341 |
|
26 |
26 |
$53.10 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
48 |
44 |
$22.12 |
| V2744 |
Tint, photochromatic, per lens |
16 |
16 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
324 |
275 |
$0.00 |