| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
346 |
331 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
442 |
434 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
650 |
611 |
$20K |
| V2020 |
Frames, purchases |
717 |
667 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
590 |
565 |
$11K |
| 92015 |
Determination of refractive state |
1,110 |
1,018 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
549 |
525 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
475 |
469 |
$860.87 |