| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,591 |
2,270 |
$204K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
835 |
743 |
$80K |
| V2020 |
Frames, purchases |
1,073 |
969 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,285 |
1,162 |
$40K |
| V2750 |
Anti-reflective coating, per lens |
1,213 |
1,098 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,323 |
1,187 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
452 |
413 |
$19K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
226 |
203 |
$18K |
| V2744 |
Tint, photochromatic, per lens |
368 |
330 |
$5K |
| 92015 |
Determination of refractive state |
3,947 |
3,439 |
$4K |
| V2781 |
Progressive lens, per lens |
60 |
51 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
12 |
$486.60 |