| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
148 |
138 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
117 |
116 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
39 |
$3K |
| V2020 |
Frames, purchases |
117 |
115 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
70 |
70 |
$552.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
16 |
$280.00 |
| V2760 |
Scratch resistant coating, per lens |
25 |
25 |
$50.00 |