| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
424 |
414 |
$28K |
| V2020 |
Frames, purchases |
1,060 |
900 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
256 |
254 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
974 |
788 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
867 |
707 |
$3K |
| 92015 |
Determination of refractive state |
795 |
783 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
41 |
31 |
$984.52 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
331 |
246 |
$265.00 |
| V2750 |
Anti-reflective coating, per lens |
111 |
76 |
$0.00 |