| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
608 |
590 |
$38K |
| 92015 |
Determination of refractive state |
1,304 |
1,275 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
226 |
221 |
$20K |
| V2760 |
Scratch resistant coating, per lens |
570 |
562 |
$9K |
| V2020 |
Frames, purchases |
841 |
826 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
353 |
350 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
525 |
520 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
273 |
267 |
$2K |
| V2755 |
U-v lens, per lens |
27 |
27 |
$390.00 |
| 3072F |
|
70 |
70 |
$0.00 |