| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
539 |
512 |
$53K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
222 |
210 |
$26K |
| V2020 |
Frames, purchases |
135 |
131 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
102 |
102 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
100 |
100 |
$2K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
13 |
13 |
$754.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$575.00 |