| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
243 |
241 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
80 |
80 |
$9K |
| V2020 |
Frames, purchases |
230 |
213 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
174 |
162 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
206 |
189 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
226 |
207 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
51 |
$2K |
| 92015 |
Determination of refractive state |
437 |
429 |
$60.50 |