| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
3,625 |
3,340 |
$169K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,446 |
1,305 |
$157K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,276 |
1,198 |
$119K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
569 |
499 |
$60K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
502 |
459 |
$28K |
| V2020 |
Frames, purchases |
613 |
545 |
$26K |
| V2750 |
Anti-reflective coating, per lens |
667 |
588 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
639 |
563 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
651 |
580 |
$12K |
| 92015 |
Determination of refractive state |
3,838 |
3,539 |
$5K |