| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,562 |
1,432 |
$142K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
768 |
715 |
$83K |
| V2020 |
Frames, purchases |
1,394 |
1,077 |
$53K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
427 |
327 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
728 |
588 |
$29K |
| 92250 |
|
612 |
589 |
$23K |
| V2750 |
Anti-reflective coating, per lens |
407 |
308 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
401 |
305 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
72 |
66 |
$5K |
| 92015 |
Determination of refractive state |
3,016 |
2,688 |
$2K |