| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
698 |
601 |
$44K |
| V2020 |
Frames, purchases |
1,108 |
938 |
$20K |
| 92015 |
Determination of refractive state |
1,393 |
1,221 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
612 |
494 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
811 |
681 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
111 |
84 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
158 |
129 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
224 |
134 |
$814.00 |
| V2760 |
Scratch resistant coating, per lens |
66 |
55 |
$0.00 |