| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
485 |
465 |
$31K |
| V2020 |
Frames, purchases |
420 |
396 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
237 |
229 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
44 |
43 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
147 |
141 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
105 |
101 |
$772.74 |
| 92015 |
Determination of refractive state |
29 |
28 |
$181.98 |
| V2760 |
Scratch resistant coating, per lens |
53 |
51 |
$98.00 |