| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,777 |
1,669 |
$96K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
733 |
698 |
$44K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,467 |
2,130 |
$40K |
| 92015 |
Determination of refractive state |
2,814 |
2,650 |
$22K |
| V2499 |
Variable sphericity lens, other type |
326 |
270 |
$21K |
| V2020 |
Frames, purchases |
1,281 |
1,025 |
$17K |
| V2750 |
Anti-reflective coating, per lens |
185 |
160 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
647 |
514 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
796 |
641 |
$8K |
| V2755 |
U-v lens, per lens |
624 |
488 |
$2K |
| V2715 |
Prism, per lens |
122 |
98 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
165 |
128 |
$2K |