| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
559 |
550 |
$32K |
| V2020 |
Frames, purchases |
1,170 |
935 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
352 |
345 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
159 |
123 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,149 |
835 |
$2K |
| 92015 |
Determination of refractive state |
972 |
951 |
$720.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
798 |
587 |
$281.18 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
840 |
586 |
$40.00 |
| V2750 |
Anti-reflective coating, per lens |
543 |
380 |
$0.00 |
| V2025 |
Deluxe frame |
122 |
112 |
$-15.66 |