| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,428 |
2,270 |
$143K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,006 |
940 |
$79K |
| V2020 |
Frames, purchases |
1,672 |
1,566 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,359 |
1,291 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,466 |
1,393 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
981 |
944 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
108 |
102 |
$6K |
| V2760 |
Scratch resistant coating, per lens |
795 |
771 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
33 |
32 |
$566.96 |
| 92015 |
Determination of refractive state |
49 |
49 |
$465.06 |
| V2755 |
U-v lens, per lens |
31 |
31 |
$375.31 |
| 3072F |
|
12 |
12 |
$0.00 |