| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
458 |
458 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,090 |
1,087 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
953 |
950 |
$13K |
| V2020 |
Frames, purchases |
1,082 |
1,079 |
$11K |
| V2760 |
Scratch resistant coating, per lens |
1,019 |
1,016 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
195 |
195 |
$9K |
| 92015 |
Determination of refractive state |
809 |
809 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,069 |
1,066 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
61 |
61 |
$847.00 |