| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99205 |
Prolong outpt/office vis |
140 |
129 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
157 |
157 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
235 |
228 |
$5K |
| 92002 |
|
30 |
30 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
30 |
30 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$445.00 |
| V2020 |
Frames, purchases |
14 |
14 |
$305.50 |