| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,115 |
2,107 |
$72K |
| V2020 |
Frames, purchases |
2,937 |
2,919 |
$53K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,322 |
1,312 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,704 |
1,699 |
$31K |
| 92015 |
Determination of refractive state |
3,405 |
3,384 |
$26K |
| 92341 |
|
379 |
379 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
333 |
332 |
$3K |
| 92250 |
|
74 |
74 |
$2K |
| 92082 |
|
32 |
32 |
$569.92 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$374.44 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$349.03 |
| 3072F |
|
14 |
14 |
$0.00 |