| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,026 |
983 |
$117K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,097 |
1,045 |
$106K |
| V2781 |
Progressive lens, per lens |
756 |
704 |
$48K |
| V2020 |
Frames, purchases |
1,018 |
951 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
673 |
635 |
$29K |
| V2750 |
Anti-reflective coating, per lens |
1,043 |
975 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,046 |
977 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,052 |
981 |
$18K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
154 |
147 |
$12K |
| V2744 |
Tint, photochromatic, per lens |
577 |
539 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
28 |
27 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
29 |
28 |
$930.15 |
| 92015 |
Determination of refractive state |
2,353 |
2,232 |
$588.01 |