| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,603 |
1,491 |
$93K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,085 |
1,964 |
$84K |
| 92015 |
Determination of refractive state |
2,834 |
2,678 |
$65K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,532 |
1,475 |
$43K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
774 |
743 |
$21K |
| V2020 |
Frames, purchases |
2,109 |
1,992 |
$19K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
538 |
522 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
670 |
422 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
426 |
247 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
202 |
178 |
$47.60 |
| V2744 |
Tint, photochromatic, per lens |
114 |
113 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
29 |
29 |
$0.00 |