| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
306 |
299 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
365 |
348 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
270 |
268 |
$8K |
| V2020 |
Frames, purchases |
260 |
255 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
235 |
230 |
$5K |
| 92015 |
Determination of refractive state |
365 |
352 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
189 |
185 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
128 |
125 |
$237.06 |