| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
657 |
586 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
457 |
411 |
$31K |
| V2020 |
Frames, purchases |
525 |
473 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
378 |
348 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
287 |
256 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
240 |
211 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
187 |
162 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
46 |
44 |
$775.70 |
| V2755 |
U-v lens, per lens |
86 |
83 |
$758.00 |
| V2760 |
Scratch resistant coating, per lens |
54 |
52 |
$102.00 |