| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,235 |
2,059 |
$140K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
815 |
791 |
$73K |
| V2020 |
Frames, purchases |
1,186 |
1,067 |
$29K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
874 |
824 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
451 |
411 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
550 |
494 |
$4K |
| 92015 |
Determination of refractive state |
743 |
696 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
81 |
76 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
36 |
36 |
$260.22 |