| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,837 |
1,806 |
$179K |
| V2020 |
Frames, purchases |
3,333 |
2,949 |
$144K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,041 |
1,012 |
$120K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,988 |
2,654 |
$95K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,410 |
1,260 |
$61K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,643 |
2,366 |
$51K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
81 |
68 |
$14K |
| V2750 |
Anti-reflective coating, per lens |
519 |
481 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
152 |
136 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
95 |
81 |
$5K |
| 92015 |
Determination of refractive state |
1,726 |
1,706 |
$2K |
| 92341 |
|
15 |
14 |
$269.75 |