| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,859 |
9,831 |
$364K |
| V2020 |
Frames, purchases |
17,336 |
17,219 |
$349K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14,023 |
13,919 |
$277K |
| 92250 |
|
3,056 |
3,050 |
$119K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,142 |
3,134 |
$107K |
| 92341 |
|
3,424 |
3,387 |
$98K |
| 92015 |
Determination of refractive state |
13,389 |
13,319 |
$95K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,008 |
1,002 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
168 |
163 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
74 |
73 |
$2K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
12 |
12 |
$582.06 |
| 2026F |
|
15 |
15 |
$0.00 |
| 2024F |
|
12 |
12 |
$0.00 |
| 3072F |
|
366 |
364 |
$0.00 |