| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
772 |
747 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
286 |
241 |
$15K |
| V2020 |
Frames, purchases |
297 |
280 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
233 |
231 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
102 |
87 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
53 |
52 |
$1K |
| V2780 |
Oversize lens, per lens |
74 |
72 |
$662.56 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$404.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$373.50 |
| V2756 |
Eye glass case |
80 |
78 |
$49.04 |