| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
940 |
860 |
$81K |
| V2781 |
Progressive lens, per lens |
814 |
567 |
$49K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
497 |
443 |
$49K |
| V2020 |
Frames, purchases |
1,262 |
921 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
713 |
522 |
$28K |
| V2750 |
Anti-reflective coating, per lens |
1,205 |
863 |
$28K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
366 |
277 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,288 |
935 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,212 |
866 |
$18K |
| V2744 |
Tint, photochromatic, per lens |
612 |
453 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
70 |
46 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
12 |
$810.54 |
| 92015 |
Determination of refractive state |
1,512 |
1,358 |
$780.08 |