| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,111 |
1,109 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,752 |
1,748 |
$35K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
618 |
616 |
$33K |
| 92015 |
Determination of refractive state |
2,127 |
2,124 |
$20K |
| V2020 |
Frames, purchases |
1,685 |
1,683 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,074 |
1,073 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,686 |
1,684 |
$7K |
| V2760 |
Scratch resistant coating, per lens |
465 |
465 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
41 |
41 |
$476.00 |