| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
317 |
312 |
$22K |
| V2020 |
Frames, purchases |
500 |
484 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
450 |
438 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
491 |
381 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
68 |
68 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
150 |
144 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
117 |
113 |
$216.00 |
| 92015 |
Determination of refractive state |
694 |
681 |
$163.51 |