| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
471 |
457 |
$27K |
| V2020 |
Frames, purchases |
1,060 |
781 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
118 |
114 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,016 |
754 |
$4K |
| 92015 |
Determination of refractive state |
889 |
866 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
959 |
704 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
69 |
64 |
$25.00 |
| V2750 |
Anti-reflective coating, per lens |
29 |
26 |
$0.00 |