| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
444 |
420 |
$24K |
| V2020 |
Frames, purchases |
436 |
366 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
269 |
256 |
$13K |
| 92015 |
Determination of refractive state |
1,345 |
1,279 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
405 |
200 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
451 |
369 |
$817.18 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
699 |
327 |
$83.18 |
| V2755 |
U-v lens, per lens |
803 |
330 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
15 |
15 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
181 |
141 |
$0.00 |