| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
588 |
581 |
$40K |
| V2020 |
Frames, purchases |
610 |
604 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
286 |
283 |
$15K |
| 92015 |
Determination of refractive state |
739 |
735 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$815.58 |
| V2760 |
Scratch resistant coating, per lens |
32 |
31 |
$240.00 |
| 2033F |
|
13 |
13 |
$0.00 |