| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
944 |
848 |
$57K |
| V2020 |
Frames, purchases |
940 |
852 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
922 |
834 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
257 |
238 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
587 |
543 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
616 |
549 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
537 |
497 |
$875.56 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
26 |
$530.76 |
| 92015 |
Determination of refractive state |
890 |
807 |
$100.00 |