| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
917 |
917 |
$99K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,247 |
1,246 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,057 |
1,057 |
$29K |
| 92015 |
Determination of refractive state |
1,329 |
1,329 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
102 |
102 |
$13K |
| V2020 |
Frames, purchases |
1,250 |
1,250 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
960 |
960 |
$0.00 |