| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
657 |
628 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
263 |
257 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
723 |
700 |
$22K |
| V2020 |
Frames, purchases |
810 |
768 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
444 |
419 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
661 |
634 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
71 |
69 |
$918.40 |
| V2760 |
Scratch resistant coating, per lens |
425 |
413 |
$816.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
37 |
$647.20 |
| 99199 |
Unlisted special service, procedure or report |
18 |
17 |
$0.00 |