| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
727 |
658 |
$78K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
582 |
530 |
$55K |
| V2020 |
Frames, purchases |
441 |
372 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
594 |
501 |
$11K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
163 |
133 |
$10K |
| V2750 |
Anti-reflective coating, per lens |
478 |
406 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
105 |
81 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
110 |
94 |
$2K |
| 92015 |
Determination of refractive state |
1,716 |
1,534 |
$1K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
28 |
26 |
$147.69 |