| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
704 |
619 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
330 |
305 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
147 |
133 |
$615.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
126 |
117 |
$375.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
132 |
127 |
$287.63 |
| V2020 |
Frames, purchases |
91 |
84 |
$94.36 |
| V2760 |
Scratch resistant coating, per lens |
28 |
24 |
$0.00 |