| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,703 |
1,632 |
$108K |
| V2020 |
Frames, purchases |
2,164 |
1,614 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,587 |
1,505 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
286 |
266 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
580 |
398 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,126 |
750 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
377 |
316 |
$7K |
| V2760 |
Scratch resistant coating, per lens |
652 |
436 |
$1K |
| 92015 |
Determination of refractive state |
50 |
50 |
$707.70 |