| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,259 |
2,127 |
$210K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,669 |
1,545 |
$170K |
| V2020 |
Frames, purchases |
2,174 |
2,022 |
$89K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,526 |
1,389 |
$61K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,213 |
2,063 |
$61K |
| V2750 |
Anti-reflective coating, per lens |
2,190 |
2,037 |
$55K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,302 |
2,119 |
$37K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
349 |
319 |
$28K |
| V2744 |
Tint, photochromatic, per lens |
1,327 |
1,230 |
$21K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
267 |
250 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
320 |
297 |
$10K |
| V2781 |
Progressive lens, per lens |
113 |
109 |
$9K |
| 92015 |
Determination of refractive state |
4,182 |
3,843 |
$2K |