| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,003 |
5,684 |
$283K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,619 |
4,362 |
$255K |
| V2020 |
Frames, purchases |
5,591 |
5,456 |
$211K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,026 |
3,952 |
$119K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,478 |
1,453 |
$75K |
| V2025 |
Deluxe frame |
1,454 |
1,449 |
$52K |
| 92015 |
Determination of refractive state |
7,633 |
7,018 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,379 |
2,343 |
$18K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
55 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
30 |
28 |
$306.66 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$289.98 |
| V2760 |
Scratch resistant coating, per lens |
12 |
12 |
$131.14 |