| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
568 |
567 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,422 |
1,418 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
547 |
546 |
$28K |
| 92015 |
Determination of refractive state |
1,546 |
1,543 |
$15K |
| V2020 |
Frames, purchases |
1,381 |
1,378 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
942 |
940 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,380 |
1,378 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
274 |
274 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
70 |
70 |
$756.00 |