| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
744 |
696 |
$47K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
956 |
877 |
$26K |
| V2020 |
Frames, purchases |
1,084 |
942 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
249 |
231 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
239 |
186 |
$3K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
157 |
146 |
$3K |
| 92015 |
Determination of refractive state |
733 |
680 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
334 |
265 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
77 |
64 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
698 |
630 |
$947.15 |