| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
939 |
857 |
$57K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
532 |
503 |
$23K |
| V2020 |
Frames, purchases |
486 |
467 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
141 |
140 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
405 |
385 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
94 |
87 |
$2K |
| 92015 |
Determination of refractive state |
1,339 |
1,250 |
$300.03 |
| V2760 |
Scratch resistant coating, per lens |
160 |
151 |
$300.01 |
| 99199 |
Unlisted special service, procedure or report |
14 |
14 |
$0.00 |
| V2702 |
Deluxe lens feature |
74 |
70 |
$0.00 |