| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
567 |
503 |
$60K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
564 |
546 |
$59K |
| 92015 |
Determination of refractive state |
1,338 |
1,225 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
538 |
468 |
$14K |
| V2760 |
Scratch resistant coating, per lens |
73 |
67 |
$0.00 |
| V2020 |
Frames, purchases |
60 |
47 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
128 |
85 |
$0.00 |