| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
214 |
204 |
$14K |
| V2020 |
Frames, purchases |
138 |
133 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
122 |
118 |
$4K |
| 92015 |
Determination of refractive state |
207 |
199 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
64 |
59 |
$492.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
24 |
$458.80 |
| V2760 |
Scratch resistant coating, per lens |
38 |
35 |
$68.00 |