| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,628 |
1,624 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
837 |
409 |
$0.00 |
| 92015 |
Determination of refractive state |
1,151 |
1,146 |
$0.00 |
| V2020 |
Frames, purchases |
1,124 |
1,103 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
78 |
38 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,727 |
846 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
365 |
364 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
273 |
134 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
15 |
$0.00 |