| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,384 |
1,360 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
652 |
642 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,840 |
1,797 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,323 |
1,301 |
$19K |
| V2020 |
Frames, purchases |
1,883 |
1,843 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
306 |
301 |
$13K |
| 92015 |
Determination of refractive state |
766 |
756 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
153 |
153 |
$3K |
| 92341 |
|
88 |
87 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
91 |
91 |
$2K |
| 3072F |
|
465 |
461 |
$150.00 |
| 2026F |
|
18 |
18 |
$0.00 |