| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
533 |
481 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
544 |
462 |
$30K |
| V2020 |
Frames, purchases |
406 |
340 |
$5K |
| V2025 |
Deluxe frame |
178 |
144 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
709 |
593 |
$646.48 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
427 |
358 |
$327.44 |
| 92015 |
Determination of refractive state |
582 |
568 |
$67.18 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
67 |
62 |
$30.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
345 |
311 |
$23.50 |
| V2750 |
Anti-reflective coating, per lens |
15 |
15 |
$0.00 |