| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
969 |
936 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
430 |
410 |
$38K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
546 |
524 |
$36K |
| V2020 |
Frames, purchases |
526 |
498 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
407 |
389 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
237 |
228 |
$2K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
56 |
56 |
$1K |
| 92015 |
Determination of refractive state |
1,277 |
1,227 |
$889.68 |
| 92341 |
|
14 |
13 |
$884.00 |
| V2755 |
U-v lens, per lens |
56 |
56 |
$709.34 |
| V2760 |
Scratch resistant coating, per lens |
270 |
263 |
$508.01 |
| 92370 |
|
15 |
15 |
$435.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
73 |
68 |
$0.00 |
| 1036F |
|
128 |
123 |
$0.00 |