| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
299 |
180 |
$18K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
316 |
180 |
$13K |
| V2020 |
Frames, purchases |
410 |
223 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
232 |
78 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
286 |
161 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
45 |
21 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
319 |
183 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$140.04 |
| 92015 |
Determination of refractive state |
372 |
215 |
$73.04 |