| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
349 |
347 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
134 |
132 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
341 |
335 |
$11K |
| V2020 |
Frames, purchases |
342 |
326 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
239 |
230 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
298 |
282 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
55 |
51 |
$798.20 |
| V2760 |
Scratch resistant coating, per lens |
278 |
262 |
$503.06 |
| 92015 |
Determination of refractive state |
29 |
29 |
$0.00 |