| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,794 |
2,621 |
$269K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,364 |
1,256 |
$147K |
| V2020 |
Frames, purchases |
2,489 |
2,088 |
$113K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,684 |
2,222 |
$105K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,926 |
1,602 |
$93K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,357 |
1,065 |
$92K |
| V2750 |
Anti-reflective coating, per lens |
2,718 |
2,233 |
$73K |
| V2781 |
Progressive lens, per lens |
1,117 |
1,005 |
$69K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,805 |
2,319 |
$48K |
| V2744 |
Tint, photochromatic, per lens |
1,204 |
1,016 |
$20K |
| 92015 |
Determination of refractive state |
4,848 |
4,461 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
13 |
$637.55 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$530.24 |