| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
538 |
512 |
$35K |
| V2020 |
Frames, purchases |
867 |
804 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
685 |
642 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
643 |
609 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
449 |
433 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
422 |
406 |
$831.62 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
15 |
$509.90 |