| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
266 |
265 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
295 |
292 |
$18K |
| 92015 |
Determination of refractive state |
836 |
824 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
367 |
306 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
379 |
374 |
$7K |
| V2020 |
Frames, purchases |
237 |
231 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
182 |
180 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
119 |
119 |
$1K |