| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
768 |
668 |
$52K |
| V2020 |
Frames, purchases |
713 |
657 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
390 |
310 |
$24K |
| 92015 |
Determination of refractive state |
1,448 |
1,248 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
813 |
774 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
331 |
315 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
830 |
767 |
$564.74 |
| V2799 |
Vision item or service, miscellaneous |
14 |
12 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
680 |
632 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$0.00 |