| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
441 |
389 |
$36K |
| 92015 |
Determination of refractive state |
1,046 |
873 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
768 |
641 |
$13K |
| V2020 |
Frames, purchases |
530 |
428 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
13 |
$650.76 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
34 |
27 |
$623.84 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
24 |
$470.82 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$456.00 |