| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
253 |
213 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
244 |
197 |
$20K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
29 |
26 |
$4K |
| V2020 |
Frames, purchases |
61 |
57 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
60 |
56 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
61 |
57 |
$946.87 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
62 |
58 |
$796.60 |