| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,951 |
5,883 |
$246K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,975 |
2,613 |
$242K |
| V2020 |
Frames, purchases |
4,692 |
2,766 |
$132K |
| V2750 |
Anti-reflective coating, per lens |
270 |
106 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
421 |
415 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
86 |
86 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,612 |
2,146 |
$3K |
| 92015 |
Determination of refractive state |
1,501 |
1,496 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
17 |
$1K |
| 3072F |
|
265 |
265 |
$0.00 |
| 2023F |
|
12 |
12 |
$0.00 |