| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
327 |
265 |
$20K |
| V2750 |
Anti-reflective coating, per lens |
169 |
163 |
$16K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
79 |
76 |
$7K |
| V2499 |
Variable sphericity lens, other type |
73 |
71 |
$6K |
| 92015 |
Determination of refractive state |
499 |
416 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
244 |
193 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
199 |
178 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
51 |
50 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
172 |
153 |
$2K |
| V2020 |
Frames, purchases |
205 |
185 |
$656.00 |