| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,650 |
5,549 |
$366K |
| V2750 |
Anti-reflective coating, per lens |
2,486 |
2,411 |
$216K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,739 |
6,630 |
$118K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,429 |
1,385 |
$116K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,980 |
5,877 |
$93K |
| V2020 |
Frames, purchases |
6,421 |
6,321 |
$85K |
| 92015 |
Determination of refractive state |
7,393 |
7,253 |
$64K |
| V2499 |
Variable sphericity lens, other type |
939 |
934 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,205 |
4,130 |
$46K |
| 92250 |
|
605 |
573 |
$21K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
37 |
37 |
$526.86 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
192 |
191 |
$2.58 |
| V2760 |
Scratch resistant coating, per lens |
356 |
352 |
$0.00 |
| V2025 |
Deluxe frame |
15 |
14 |
$0.00 |