| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,721 |
3,497 |
$223K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,664 |
2,533 |
$165K |
| 92060 |
|
4,697 |
4,475 |
$106K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,238 |
1,173 |
$98K |
| 92283 |
|
4,351 |
4,143 |
$60K |
| V2020 |
Frames, purchases |
348 |
259 |
$3K |
| 92370 |
|
29 |
27 |
$754.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
103 |
69 |
$420.00 |
| S9999 |
Sales tax |
12 |
12 |
$26.28 |