| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
693 |
640 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
380 |
361 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
240 |
232 |
$11K |
| 92015 |
Determination of refractive state |
230 |
209 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
133 |
125 |
$4K |
| V2025 |
Deluxe frame |
303 |
293 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
18 |
18 |
$0.00 |