| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
738 |
693 |
$51K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,185 |
1,107 |
$19K |
| V2499 |
Variable sphericity lens, other type |
174 |
162 |
$11K |
| 92015 |
Determination of refractive state |
1,127 |
1,060 |
$9K |
| V2020 |
Frames, purchases |
187 |
175 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
29 |
28 |
$3K |
| V2755 |
U-v lens, per lens |
185 |
173 |
$680.00 |
| 92250 |
|
13 |
13 |
$564.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
185 |
173 |
$3.38 |