| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,778 |
1,647 |
$197K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,101 |
1,927 |
$193K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,986 |
1,494 |
$84K |
| V2020 |
Frames, purchases |
1,913 |
1,445 |
$84K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
994 |
736 |
$70K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,396 |
1,040 |
$68K |
| V2750 |
Anti-reflective coating, per lens |
1,977 |
1,488 |
$51K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,027 |
1,526 |
$33K |
| V2781 |
Progressive lens, per lens |
578 |
399 |
$27K |
| V2744 |
Tint, photochromatic, per lens |
1,399 |
1,112 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
29 |
25 |
$1K |
| 92015 |
Determination of refractive state |
3,959 |
3,590 |
$943.41 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
12 |
$673.64 |