| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
286 |
273 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
103 |
94 |
$7K |
| V2020 |
Frames, purchases |
81 |
74 |
$3K |
| V2781 |
Progressive lens, per lens |
35 |
33 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
78 |
71 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
81 |
74 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
29 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
79 |
72 |
$1K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
12 |
12 |
$770.00 |
| 92015 |
Determination of refractive state |
607 |
564 |
$120.00 |