| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
886 |
878 |
$61K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
609 |
606 |
$56K |
| V2020 |
Frames, purchases |
1,313 |
1,239 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,257 |
1,222 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
483 |
451 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,027 |
958 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
53 |
52 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
564 |
539 |
$1K |
| 92015 |
Determination of refractive state |
117 |
117 |
$363.96 |