| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
434 |
426 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
345 |
333 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
551 |
531 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
895 |
867 |
$1K |
| V2020 |
Frames, purchases |
892 |
860 |
$538.96 |
| 92015 |
Determination of refractive state |
1,067 |
1,040 |
$60.35 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
569 |
548 |
$52.18 |
| V2760 |
Scratch resistant coating, per lens |
69 |
69 |
$0.00 |