| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
700 |
657 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
311 |
288 |
$34K |
| V2020 |
Frames, purchases |
493 |
390 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
430 |
334 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
499 |
395 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
79 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
147 |
111 |
$2K |
| 92015 |
Determination of refractive state |
1,639 |
1,531 |
$1K |