| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
227 |
204 |
$12K |
| 92015 |
Determination of refractive state |
462 |
398 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
139 |
120 |
$5K |
| V2020 |
Frames, purchases |
348 |
300 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
223 |
197 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
169 |
149 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
227 |
196 |
$1K |
| V2025 |
Deluxe frame |
12 |
12 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
46 |
43 |
$0.00 |
| V2755 |
U-v lens, per lens |
120 |
105 |
$0.00 |