| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
292 |
281 |
$19K |
| V2020 |
Frames, purchases |
347 |
322 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
264 |
250 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
304 |
291 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
156 |
144 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
112 |
105 |
$239.22 |