| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,738 |
2,696 |
$270K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,866 |
1,831 |
$220K |
| V2020 |
Frames, purchases |
3,029 |
2,940 |
$115K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,560 |
1,517 |
$71K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,943 |
2,870 |
$64K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
495 |
483 |
$61K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,991 |
2,897 |
$52K |
| V2750 |
Anti-reflective coating, per lens |
1,828 |
1,787 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
122 |
121 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
39 |
$2K |
| 92310 |
|
12 |
12 |
$1K |
| 92250 |
|
21 |
19 |
$911.20 |
| 92015 |
Determination of refractive state |
379 |
376 |
$670.09 |