| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
572 |
565 |
$21K |
| V2020 |
Frames, purchases |
1,146 |
1,129 |
$14K |
| 92015 |
Determination of refractive state |
743 |
729 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
264 |
262 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
91 |
88 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
209 |
203 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
249 |
249 |
$2K |
| 92341 |
|
123 |
120 |
$2K |
| V2755 |
U-v lens, per lens |
236 |
236 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
16 |
$311.04 |