| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,628 |
1,577 |
$163K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
700 |
680 |
$90K |
| V2020 |
Frames, purchases |
1,361 |
1,303 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
459 |
441 |
$55K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,180 |
1,138 |
$38K |
| V2750 |
Anti-reflective coating, per lens |
1,199 |
1,156 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,142 |
1,103 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
429 |
403 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
18 |
$837.72 |
| 92015 |
Determination of refractive state |
2,440 |
2,350 |
$785.26 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$745.62 |