| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,771 |
1,734 |
$67K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,788 |
1,747 |
$32K |
| V2020 |
Frames, purchases |
2,551 |
2,448 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,693 |
1,608 |
$29K |
| 92015 |
Determination of refractive state |
2,538 |
2,491 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
540 |
536 |
$20K |
| V2750 |
Anti-reflective coating, per lens |
967 |
943 |
$20K |
| V2760 |
Scratch resistant coating, per lens |
1,095 |
1,071 |
$11K |
| V2755 |
U-v lens, per lens |
1,130 |
1,103 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
540 |
503 |
$5K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
69 |
69 |
$4K |
| 92341 |
|
155 |
155 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
57 |
57 |
$885.40 |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
13 |
13 |
$832.00 |
| 92310 |
|
16 |
14 |
$507.00 |
| V2744 |
Tint, photochromatic, per lens |
13 |
13 |
$480.00 |
| V2781 |
Progressive lens, per lens |
12 |
12 |
$448.00 |